未行调脂治疗的冠心病患者血浆前蛋白转化酶枯草溶菌素9水平与促甲状腺激素的相关性分析  

Relationship between serum PCSK9 and TSH levels in coronary heart disease patients who did not receive lipid-lowering therapy

作　　者：王梅[1] 李艳芳[1] 郭彦青[1] 陈萌萌[1] 蒋志丽[1] 宋俊迎 

机构地区：[1]首都医科大学附属北京安贞医院急危重症中心急诊综合病房,100029

出　　处：《中华老年心脑血管病杂志》2017年第11期1153-1156,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨未行调脂治疗的冠心病患者血浆前蛋白转化酶枯草溶菌素9(PCSK9)与血脂各指标,甲状腺功能等影响因素的相关性。方法选择2013年7月~2014年3月在首都医科大学附属北京安贞医院就诊的未行调脂治疗的胸痛患者160例,入院后根据冠状动脉造影结果分为冠心病组102例和对照组58例。收集临床资料,采集空腹静脉血,检测血常规、血生化、甲状腺功能等各项指标。结果冠心病组糖尿病、吸烟、空腹血糖、糖化血红蛋白、LDL-C明显高于对照组,HDL-C明显低于对照组,差异有统计学意义(P<0.01)。冠心病组促甲状腺激素(TSH)及PCSK9明显高于对照组[(2.26±1.49)mU/L vs(1.88±0.98)mU/L,P=0.038;(0.29±0.28)mg/L vs(0.15±0.22)mg/L,P=0.027]。logistic回归分析显示,年龄、吸烟、糖尿病、TSH、LDL-C、HDL-C、脂蛋白(a)、PCSK9是冠心病患者的危险因素(P<0.05)。冠心病患者血浆PCSK9与LDL-C、载脂蛋白B、TSH呈正相关(r=0.524,P=0.004;r=0.412,P=0.021;r=0.571,P=0.021)。结论 TSH和PCSK9共同参与了动脉粥样硬化的形成和发展。PCSK9与TSH存在相关性,两者共同影响了冠心病的发生、发展。Objective To study the relationship between serum PCSK9 level and its influencing factors（blood lipid profile and thyroid function）in CHD patients who did not receive LLT.Methods One hundred and sixty chest pain patients who did not receive LLT were divided into CHD group（n=102）and control group（n=58）according their coronary arteriographic findings after admission.Their clinical data,blood routine examination data,blood biochemical testing data and thyroid function were recorded.Results The incidence of diabetes was significantly higher,the history of smoking was significantly longer,the serum levels of FPG,HbA1 c,LDL-C were significantly higher and that of HDL-C was significantly lower in CHD group than in control group（P〈0.01）.The serum levels of thyroid-stimulating hormone（TSH）and PCSK9 were significantly higher in CHD group than in control group（2.26±1.49 mU/Lvs 1.88±0.98 mU/L,P=0.038;0.29±0.28 mg/Lvs 0.15±0.22 mg/L,P=0.027）.Logistic regression analysis showed that age,smoking,diabetes,serum levels of TSH,LDL-C,HDL-C,Lp（a）,and PCSK9 were the independent risk factors for CHD（P〈0.05）.The serum PCSK9 level was positively related with those of LDL-C,apoB,and TSH（r=0.524,P=0.004;r=0.412,P=0.021;r=0.571,P=0.021）.Conclusion TSH and PCSK9 are involved in the formation and progression of atherosclerosis,and can thus exerte their effect on the occurrence and progression of CHD.

关 键 词：冠心病 促甲状腺素 血脂异常 动脉粥样硬化 前蛋白转化酶类 枯草杆菌蛋白酶类 

分 类 号：R541.4[医药卫生—心血管疾病]