鞘磷脂与冠状动脉粥样硬化性心脏病患者冠状动脉狭窄程度的相关性研究  

Correlation Study between Sphingomyelin and Degree of Coronary Artery Stenosis in Patients with Coronary Atherosclerotic Heart Disease

作　　者：王尹曼[1] 陈学颖[1] 徐磊[1] 赵吉[1] 徐馨[2] 吴召娣 邵文琦[3] 孙爱军[1] 葛均波[1] 

机构地区：[1]复旦大学附属中山医院心内科,上海200032 [2]复旦大学附属中山医院肝肿瘤内科,上海200032 [3]复旦大学附属中山医院检验科,上海200032

出　　处：《中国临床医学》2015年第3期310-313,317,共5页Chinese Journal of Clinical Medicine

基　　金：国家重点基础研究发展计划(编号:2011CB503905);复旦大学附属中山医院青年基金(编号:2012ZSQN26)

摘　　要：目的：探讨冠状动脉粥样硬化性心脏病（冠心病）患者入院时血浆鞘磷脂（sphingomyelin,SM）水平与冠状动脉病变程度间的相关性。方法：回顾分析行冠状动脉造影术的464例患者的临床资料,其中男性345例,女性119例;平均年龄（62.71±0.46）岁。464例中冠状动脉造影正常者137例,冠状动脉狭窄者为327例。根据Gensini评分计算冠状动脉狭窄的严重程度。检测所有患者入院时SM水平。结果：冠脉正常组和冠脉狭窄组的SM水平分别为（394.5±9.1）、（450.5±7.8）mg/L,两组差异有统计学意义（P〈0.001）。SM与Gensini评分呈正相关（r=0.155,P=0.001）。按照SM水平三分位分组的Gensini评分分别为6（0-38）、18（2-50）、19（0-49）,3组间Gensini评分的差异有统计学意义（P=0.035）。多元线性回归分析显示,在校正了多个相关危险因素后,血SM水平与Gensini评分独立相关[β=0.143,95%可信区间（95%CI）：0.148-0.654,P=0.002]。结论：SM与冠状动脉造影Gensini评分呈正相关,其水平可能是预测冠心病患者冠脉狭窄程度的独立危险因素。SM可能为冠心病的治疗提供了新靶点。Objective：To investigate the correlation between the plasma sphingomyelin（SM）levels and the severity of coronary artery disease in patients with coronary atherosclerotic heart disease（CAD）on admission.Methods：Clinical data of 464 patients undergoing coronary angiography were retrospectively analyzed,which included 345 male cases and 119 female cases with mean age of 62.71±0.46.The patients were divided into stenosis group（n=327）and normal group（n=137）according to the results of coronary angiography.The severity of coronary artery stenosis was calculated according to Gensini score.The SM levels of all patients were measured on admission.Results：SM levels in control group and stenosis group were 39.45±0.91mg/dL,45.05±0.78 mg/dL,respectively,and the difference between the two groups was statistically significant（P〈0.001）.SM levels were positively correlated with Gensini scores（r=0.155,P=0.001）.The Gensini scores according to their tertiles of SM levels were 6（0-38）,18（2-50）,19（0-49）,respectively.The differences regarding Gensini scores among the three groups were statistically significant（P=0.035）.After multiple related risk factors had been corrected,the multivariate linear regression analysis showed that plasma SM levels were independently associated with Gensini scores（β=0.143,95%CI0.148-0.654,P=0.002）.Conclusions：SM level was significantly associated with coronary angiography Gensini score,and its level might be an independent risk factor for predicting the degree of coronary stenosis.SM might provide novel therapeutic target for the treatment of CAD.

关 键 词：冠心病 鞘磷脂 冠脉狭窄程度 

分 类 号：R541.4[医药卫生—心血管疾病]