急性冠状动脉综合征合并2型糖尿病患者血浆过氧化物酶体增殖物激活受体γ与冠状动脉病变严重程度及斑块稳定性的相关性研究  

Correlation between PPARγ and coronary stenosis and plaque stabilit of patients with ACS and T2DM

作　　者：孙青[1] 李晓燕[1] 刘娟[1] 张红明[1] 张国明[1] 韩淑芳[1] 陈英剑[2] 

机构地区：[1]济南军区总医院心内科,山东济南250031 [2]济南军区总医院检验科

出　　处：《中国介入心脏病学杂志》2014年第8期497-500,共4页Chinese Journal of Interventional Cardiology

摘　　要：目的探讨血浆过氧化物酶体增殖物激活受体γ(PPARγ)对急性冠状动脉综合征(ACS)合并2型糖尿病(T2DM)患者冠状动脉病变程度及斑块稳定性的影响。方法选取确诊的ACS患者102例,其中合并2型糖尿病52例(51.0%,ACS+T2DM组),单纯ACS患者50例(49.0%,ACS组)。选取正常对照30例(对照组)。行冠状动脉造影术(CAG)并应用Gensini积分系统进行冠状动脉狭窄程度评估;所有患者抽取静脉血应用ELISA检测血浆PPARγ、基质金属蛋白酶-9(MMP-9)水平,并进行相关性分析。结果 ACS+T2DM组Gensini积分显著大于ACS组(P<0.05)。与对照组相比,ACS+T2DM组、ACS组血浆PPARγ水平下降,MMP-9浓度显著升高,ACS+T2DM组PPARγ下降、MMP-9升高更明显,组间比较差异均有统计学意义(P均<0.05)。ACS+T2DM组PPARγ浓度与Gensini积分(r=-0.416,P<0.05)、MMP-9浓度(r=-0.503,P<0.05)均呈负相关趋势。结论合并2型糖尿病能够加剧ACS患者冠状动脉病变及斑块不稳定程度,PPARγ可能在其中起保护作用。Objective To investigate the effect of PPARγ in acute coronary syndrome （ACS） patients with type 2 diabetes （T2DM） for the severity of coronary atherosclerosis and plaque stability. Methods We selected 102 patients with ACS, including 52 patients with type 2 diabetes mellitus （ACS＋T2DM group） and 50 patients with simply ACS （ACS group）. Meanwhile, we selected 30 patients without coronary heart disease and T2DM as the control group. All basic clinic data, CAG and the Gensini score were compared among all groups. To all patients, blood was drew when they were enrolled to detect the level of PPARγ and MMP-9. Results Gensini points in the ACS＋T2DM group was much higher than that of the ACS group （P 〈 0.05）. The levels of PPARγ of the ACS group and the ACS＋T2DM group, when compared with the control group, were decreased significantly, but the level of MMP-9 were＆amp;nbsp;increased （all P 〈 0.05）. The level of PPARγ in the ACS＋T2DM group was much lower than the ACS group, and the level of MMP-9 was much higher （P〈0.05）. Gensini scores （r=-0.416, P〈0.05）, the level of MMP-9（r= - 0.503, P 〈 0.05） were correlated negatively with the level of PPARγ. Conclusions Complicating with T2DM can aggravate coronary artery disease and plaque instability degree in ACS patients, and PPARγpossibly make an protective effect.

关 键 词：急性冠状动脉综合征 2型糖尿病 过氧化物酶体增殖物激活受体Γ 基质金属蛋白酶-9 GENSINI积分 

分 类 号：R541.4[医药卫生—心血管疾病]