血清胸腺基质淋巴细胞生成素与稳定型心绞痛患者内皮功能和冠状动脉病变的关系  

Relationship between serum TSLP and endothelial function and coronary artery lesion in patients with stable angina pectoris

作　　者：陈宝峰[1] 邓芸[2] 徐新[1] 马绍椿[1] 唐良秋[1] 肖雨雄[2] 陈锦峰[1] 陈云宪 梁家荣[1] 孙维倩 CHEN Bao-feng;DENG Yun;XU Xin;MA Shao-chun;TANG Liang-qiu;XTAO Yu-xiong;CHEN Jin-feng;CHEN Yun-xian;LIANG Jia-rong;SUN Wei-qian(Department of Cardiovasology Yuebei People's Hospital,Shaoguan 512026,China;Department ofUltrasound Yuebei People's Hospital,Shaoguan 512026,China)

机构地区：[1]粤北人民医院心血管内科,广东省韶关市512026 [2]粤北人民医院超声诊断科,广东省韶关市512026

出　　处：《中国心血管病研究》2019年第2期139-142,共4页Chinese Journal of Cardiovascular Research

基　　金：韶关市科技计划项目(项目编号:2017CX/012).

摘　　要：目的 研究血清胸腺基质淋巴细胞生成素(TSLP)水平与稳定型心绞痛(SAP)患者肱动脉内皮功能及冠状动脉病变的关系。方法 连续收集2017年5~11月在我院心血管内科经冠状动脉造影确诊的SAP患者279例和非冠心病者75例(对照组);术前空腹留取血清待检TSLP和应用超声无创性检测肱动脉血流介导的内皮依赖性血管舒张功能(FMD)以评估血管内皮功能。应用改良Gensini积分评估冠状动脉病变的严重程度,根据结果进一步将SAP患者分为重度、中度和轻度病变亚组。结果 与对照组比较,SAP组FMD显著降低[(7.5±3.1)%比(13.2±3.8)%,P<0.01],而血清TSLP水平则显著升高[(258.2±59.2)pg/mL比(153.7±48.4)pg/mL,P<0.01]。在SAP三个亚组间比较,随冠状动脉病变由轻到重,FMD逐渐降低(P<0.01),血清TSLP逐渐升高(P<0.05);Logistic回归分析显示,血清TSLP是冠状动脉重度病变的独立危险因素(OR=1.707,95%CI: 1.334~2.184,P<0.01)。血清TSLP与FMD呈直线负相关(r=-0.402,P<0.01);进一步多因素分析排除其他心血管危险因素的干扰后,前述两者之间仍存在负相关关系(β′=-0.311,P<0.01)。结论 SAP患者血清TSLP水平与肱动脉内皮功能和冠状动脉病变严重程度密切关系,提示TSLP可能参与了冠心病的病理生理过程。Objective To investigate the relationship between serum thymic stromal lymphopoietin (TSLP) and endothelial dysfunction and coronary artery lesion in patients with stable angina pectoris(SAP) and its clinical significance. Methods A total of 354 consecutively admitted patients suspected for SAP who underwent examination of coronary angiography(CAG) were enrolled. According to the results of CAG, they were divided into normal control group(75 cases) and SAP group(279 cases). Level of serum TSLP was measured by ELISA, and flow-mediated dilation(FMD) in right brachial artery was detected to reflect endothelial function by ultrasound in all subjects before CAG. Modified Gensini score was used to assess the severity of coronary artery lesion, and the SAP group was further divided into mild, moderate and severe lesion subgroups. Results Compared with that in control group, the FMD in SAP group was significantly decreased[(7.5±3.1)% vs (13.2±3.8)%, P<0.01], while the serum level of TSLP was significantly increased[(258.2±59.2)pg/mL vs (153.7±48.4)pg/mL, P<0.01]. Among three SAP subgroups, with the increase of lesion degree of coronary artery, the level of serum TSLP ascended gradually(P<0.05), while the FMD descended gradually(P<0.01). Non-conditional Logistic stepwise regression analysis showed that serum TSLP level was the independent risk factor for severe lesion of coronary artery(OR=1.707,95%CI: 1.334~2.184,P<0.01). Serum TSLP level was negatively correlated with FMD in SAP group(r=-0.402, P<0.01), and the correlation persisted after adjusting other risk factor under the control of multiple linear regression model(β′=-0.311, P<0.01). Conclusion The level of serum TSLP is closely related to the endothelial dysfunction of brachial artery and the severity of coronary artery lesion in patients with SAP. The study suggests that serum TSLP may be involved in the pathophysiological process of coronary artery disease.

关 键 词：胸腺基质淋巴细胞生成素 稳定型心绞痛 内皮功能 GENSINI积分 

分 类 号：R541.4[医药卫生—心血管疾病]