前蛋白转化酶枯草溶菌素9水平与肱-踝脉搏波传导速度和踝臂指数的相关性  

The correlation between human serum PCSK9 with brachial ankle pulse wave velocity and ankle brachial index

作　　者：Esam.L.Q.Mohammed 石光耀 刘定辉[1] 温仁辉 钱孝贤[1] Esam. L. Q. Mohammed;SHI Guang - yao;LIU Ding - hui;WEN Ren - hui;QIAN Xiao - xian(Department of Cardiology,the Third Affiliated Hospital of Sun Yat - sen University,Guangzhou 510630,Gunagdong,China)

机构地区：[1]中山大学附属第三医院心血管内科

出　　处：《广东医学》2019年第10期1381-1385,共5页Guangdong Medical Journal

基　　金：国家自然科学基金资助项目(编号:81370447);广东省科技计划项目-国际科技合作领域(编号:2016A050502014)

摘　　要：目的探索血清前蛋白转化酶枯草溶菌素9(PCSK9)水平与肱-踝动脉搏波传导速度(Ba-PWV)和踝臂指数(ABI)之间的关系。方法连续入组符合纳入标准的139例心血管内科入院患者,收集临床信息,仪器测得Ba-PWV和ABI值。入组患者根据Ba-PWV分为Ba-PWV升高组(n=87,Ba-PWV≥1 400 cm/s)和Ba-PWV正常组(n=52,Ba-PWV<1 400 cm/s),根据ABI分为ABI降低组(n=55,ABI<0.9)和ABI正常组(n=84,ABI≥0.9)。收集空腹静脉血测定PCSK9。结果与Ba-PWV正常组比较,Ba-PWV升高组患者年龄大、吸烟人数多、脂蛋白a[Lp(a)]、PCSK9以及超敏C反应蛋白(hs-CRP)水平高(P<0.05)。回归分析显示年龄、吸烟、PCSK9是Ba-PWV的主要影响因素(P<0.05)。以年龄、吸烟、ABI为控制变量,偏相关性分析显示Ba-PWV指数和PCSK9水平呈正相关(P<0.001)。与ABI正常组比较,ABI降低组患者年龄大、男性多、Lp(a)、PCSK9及hs-CRP水平高(P<0.05)。回归分析示年龄、PCSK9是ABI的主要影响因素(P<0.001)。以年龄、Ba-PWV为控制变量,偏相关性分析显示ABI和PCSK9水平呈负相关(P<0.001)。结论血清PCSK9水平与大动脉及外周动脉粥样硬化程度呈正相关,可能成为临床预测及评估动脉粥样硬化相关血管病变的血清学指标。Objective To investigate the correlation between human serum proprotein convertase subtilisin /kexin type 9( PCSK9) with brachial ankle pulse wave velocity ( Ba - PWV) and ankle brachial index ( ABI). Methods A to- tal of 139 hospitalized patients from Cardiovascular Department were enrolled in this study. The basic clinical information were collected,and values of Ba - PWV and ABI were automatically measured by the automatic analyzer. The recruited subjects were allocated to 2 groups based on the Ba - PWV,high Ba - PWV group ( n = 87,Ba - PWV≥1 400 cm/s) and normal Ba - PWV group ( n = 52,Ba - PWV < 1 400 cm/s). According to ABI,the participants were also divided in- to 2 groups,low ABI group ( n = 55,ABI < 0. 9) and normal ABI group ( n = 84,ABI≥0. 9). Meanwhile,fasting venous blood was collected and the level of serum PCSK9 was determined with ELISA kit. Results Comparison between the high Ba - PWV group and the normal Ba - PWV group showed that older age ( P = 0. 021),more smokers ( P = 0. 010) and higher lipoprotein ( a)[Lp( a)],PCSK9 and high - sensitivity C - reactive protein ( hs - CRP) levels were observed in the high Ba - PWV group ( P < 0. 05). Binary logistic regression analysis showed that age,smoking and PCSK9 were the significantly influencing factors of Ba - PWV ( P < 0. 05). A positive correlation of Ba - PWV with PCSK9 were revealed ( r = 0. 603,P < 0. 001). Comparison between the low ABI group and the normal ABI group showed that older age ( P = 0. 000),more males ( P = 0. 013) and higher Lp( a),PCSK9 and hs - CRP levels were observed in the low ABI group ( P < 0. 05). Binary logistic regression analysis showed that age and PCSK9 were the significantly influencing factors of ABI ( P < 0. 01). A significantly negative correlation of ABI with PCSK9 were observed ( r =- 0. 535,P < 0. 001). Con- clusion The serum PCSK9 level is positively correlated with arterial and peripheral atherosclerosis. It may become a no- vel serological index for clinical prediction and evaluation of atherosclerotic v

关 键 词：动脉粥样硬化 前蛋白转化酶枯草溶菌素9 肱-踝动脉搏波传导速度 踝臂指数 

分 类 号：R543.5[医药卫生—心血管疾病] R446.61[医药卫生—内科学]