冠状动脉侧支循环形成与血管生成素1和2的相关性研究  

Correlation between angiopoietin-1,angiopoietin-2 and coronary collateral circulation formation in patients with coronary heart disease

作　　者：李振宇[1] 李传昶[1] 杨天伦[1] 蒲晓群[1] 易军[1] 欧阳冬生[2] 

机构地区：[1]中南大学湘雅医院心内科,长沙410008 [2]中南大学临床药理研究所

出　　处：《中国心血管杂志》2012年第2期109-112,共4页Chinese Journal of Cardiovascular Medicine

摘　　要：目的探讨冠状动脉严重狭窄患者的冠状动脉侧支循环(CCC)形成与血清血管生成素1(Ang-1)和2(Ang-2)浓度的关系。方法入选冠状动脉造影示左前降支、左回旋支和右冠状动脉中至少1支狭窄≥90%的患者67例,按照Rentrop分级方法,对CCC进行分级:0级22例,1级17例,2级18例,3级10例;采用酶联免疫吸附法检测患者血清Ang-1、Ang-2浓度;应用Gensini积分系统评价患者的冠状动脉粥样硬化病变程度。结果 0和1级组(冠状动脉侧支形成不良)血清Ang-1水平[(622.59±47.75)ng/L和(728.00±35.82)ng/L]明显低于2和3级组[冠状动脉侧支形成良好,(984.39±88.34)ng/L和(1169.80±48.18)ng/L,均为P<0.01];而0和1级组血清Ang-2水平[(798.23±70.48)ng/L和(732.35±36.26)ng/L]明显高于2和3级组[(562.56±81.85)ng/L和(450.80±41.19)ng/L,均为P<0.01]。CCC分级与血清Ang-1浓度呈正相关(r偏=0.81,P<0.01),与血清Ang-2浓度呈负相关(r偏=-0.69,P<0.01)。血清Ang-1浓度与Gensini积分呈正相关(r偏=0.29,P<0.05),血清Ang-2浓度与Gensini积分无相关性(P>0.05)。结论冠状动脉严重狭窄患者,随着血清Ang-1浓度增加或(和)Ang-2浓度下降,其侧支循环越发达,Ang-1可能促进了CCC的生成,而Ang-2可能抑制了CCC的生成。Objective To investigate the correlation between serum angiopoietin-1 （ Ang-1 ）, Ang-2 levels and coronary collateral circulation （CCC） formation in coronary heart disease （CHD） patients with severe coronary stenosis. Methods A total of 67 CHD patients with severe coronary stcnosis were included according to the results of coronary angiography. CCC formation was graded using Rentrop Grading System： degree 0 （ n = 22）, degree 1 （n = 17）, degree 2 （ n = 18） and degree 3 （ n = 10）. Serum concentrations of Ang-1 and Ang-2 were measured by ELISA and the extent of coronary artery atherosclerosis was evaluated by Gensini＇s score. Results Serum Ang-1 level in CHD patients with poor CCC （degree 0 and 1 ） [ （644. 18 ±63.20） ng/L] was significantly lower than that with good CCC （ degree 2 and 3） [ （ 1050. 61 ± 117. 70） ng/L, P 〈0. 01 ]. Serum Ang-2 level in patients with good CCC （degree 2 and 3 ） [ （522. 64 ± 88.08） ng/L] was significantly lower than that with poor CCC （degree 0 and 1 ） [ （769. 51 ± 66. 28 ） ng/L, P 〈 0. 01 ]. CCC formation was positively correlated with serum Ang-I （ r = 0. 81, P 〈 0. 01 ） and negatively correlated with serum Ang-2 level （r = -0. 69, P 〈 0. 01 ）. Serum Ang-1 level was positively correlated with Gensini＇s score （r =0. 29,P 〈0. 05）, while Ang-2 was not correlated with Gensini＇s score （P 〉0. 05）. Conclusions In patients with severe coronary artery stenosis, Ang-1 may promote the formation while Ang-2 may inhibit CCC formation.

关 键 词：冠状动脉侧支循环 血管生成素1 血管生成素2 GENSINI积分 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病]