冠状动脉粥样硬化性心脏病患者血浆前蛋白转化酶枯草溶菌素9与组织因子的相关性分析  

Correlation between plasma proprotein convertase subtilisin/kexin type 9 and tissue factor in patients with coronary heart disease

作　　者：王梅[1] 李艳芳[1] 郭彦青[1] 陈萌萌[1] 蒋志丽[1] 宋俊迎 Wang Mei, Li Yanfang, Guo Yanqing, Chen Mengmeng, Jiang Zhili, Song Junying(Emergency and Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Belting 100029, Chin)

机构地区：[1]首都医科大学附属北京安贞医院急诊危重症中心,100029

出　　处：《中国医药》2018年第7期982-985,共4页China Medicine

基　　金：国家自然科学基金(81270380)~~

摘　　要：目的探讨未行降脂治疗的冠状动脉粥样硬化性心脏病(冠心病)患者血浆前蛋白转化酶枯草溶菌素9(PCSK9)与组织因子的相关性。方法选择2013年7月至2014年3月因胸痛到首都医科大学附属北京安贞医院就诊的患者210例,均未服用他汀及其他降脂药物,根据冠状动脉造影结果分为观察组(120例)及对照组(90例),观察组分为急性冠状动脉综合征(ACS)亚组(31例)和稳定型冠心病(SCAD)亚组(89例),检测患者血脂和血浆PCSK9与组织因子等指标,分析PCSK9与血脂和组织因子的相关性,应用Logistic回归分析冠心病的危险因素。结果观察组吸烟及糖尿病史比例高于对照组[62.5%(75/120)比52.2%(47/90),30.8%(37/120)比16.7%(15/90)],低密度脂蛋白胆固醇、PCSK9水平高于对照组[(3.0±1.2)mmol/L比(2.7±0.9)mmol/L,(0.29±0.08)mg/L比(0.15±0.04)mg/L],高密度脂蛋白胆固醇低于对照组[(1.03±0.25)mmol/L比(1.13±0.26)mmol/L],差异均有统计学意义(均P<0.05)。Logistic回归分析显示,在调整了患者性别、高血压等因素后发现,年龄增大、吸烟史、糖尿病史、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、载脂蛋白B、脂蛋白a、总胆固醇、PCSK9是冠心病的独立危险因素(均P<0.05)。观察组和对照组的组织因子检测结果比较差异无统计学意义(P>0.05),观察组中ACS亚组患者组织因子水平高于SCAD亚组[(129±23)ng/L与(116±20)ng/L]及对照组(均P<0.05),ACS亚组患者血浆PCSK9水平和组织因子水平呈正相关(r=0.509,P=0.001)。结论 PCSK9是冠心病的独立危险因素,与动脉粥样硬化的形成和发展有密切关系。ACS患者血浆PCSK9水平与组织因子水平正相关,提示PCSK9、组织因子可能与动脉粥样硬化斑块的破裂相关。ObjectiveTo investigate the relation between plasma proprotein convertase subtilisin/kexin type 9（PCSK9） and tissue factor（TF） in patients with coronary artery disease（CAD）. MethodsA total of 210 patients with chest pain who visited Beijing Anzhen Hospital, Capital Medical University from July 2013 to March 2014 were enrolled; all patients have not been treated with statins and other types of lipid-lowering agents. They were divided into CAD group（n=120） and control group（without CAD）（n=90） based on coronary angiography Results; patients in CAD group were divided into acute coronary syndrome（ACS） group（n=31） and stable CAD（SCAD） group（n=89）. Plasma levels of PCSK9 and TF were tested and the correlation between them was analyzed. Risk factors of CAD were analyzed by logistic regression. ResultsRatios of smoking history and diabetes history in CAD group were significantly higher than those in control group[62.5%（75/120）vs 52.2%（47/90）, 30.8%（37/120）vs 16.7%（15/90）]; levels of low-density lipoprotein cholesterol（LDL-C） and PCSK9 in CAD group were significantly higher than those in control group[（3.0±1.2）mmol/L vs（2.7±0.9）mmol/L, （0.29±0.08）mg/L vs（0.15±0.04）mg/L]; high-density lipoprotein cholesterol（HDL-C） level in CAD group was significantly lower than that in control group[（1.03±0.25）mmol/L vs（1.13±0.26）mmol/L]（all P〈0.05）. Logistic regression analysis showed that advanced age, smoking history, diabetes history, LDL-C, HDL-C, apolipoprotein-B, apolipoprotein-a, total cholesterol and PCSK9 were independent risk factors of CAD（P〈0.05）. TF level showed no significant difference between CAD group and control group（P〉0.05）. TF level in ACS group was significantly higher than that in SCAD group[（129±23）ng/L vs（116±20）ng/L]（P〈0.05）. In ACS group, PCSK9 level was positively correlated with TF level（r=0.509, P=0.001）. ConclusionsPCSK9 is an independent risk factor of CAD and it is closely rel

关 键 词：冠状动脉粥样硬化性心脏病 前蛋白转化酶枯草溶菌素9 组织因子 

分 类 号：R541.4[医药卫生—心血管疾病]