老年冠心病患者脂肪细胞因子与冠状动脉病变严重程度的相关性  

Association between adipocytokines levels and coronary artery lesions in elderly patients with coronary heart disease

作　　者：刘艳宾[1] 杨树涵[1] 陈红伟[1] 邢永生[1] LIU Yanbin;YANG Shuhan;CHEN Hongwei;XING Yongsheng(Department of Vasculocardiology,Xinxiang City Central Hospital,Xinxiang 453100,China)

机构地区：[1]新乡市中心医院心血管内科

出　　处：《实用医学杂志》2019年第11期1799-1804,共6页The Journal of Practical Medicine

基　　金：河南省医学科技攻关计划项目(编号:201503059)

摘　　要：目的探讨冠心病(CHD)患者血清内脂素、Chemerin、网膜素-1、Vaspin及SFRP5水平与冠状动脉病变程度的相关性。方法回顾性纳入本院2016年6月1日至2018年7月1日共187例CHD患者和45例健康体检者作为研究对象,根据Gensini积分将CHD患者分为轻、中度和重度病变组,评估CHD患者与对照组在性别、年龄、BMI、合并高血压及糖尿病、尿酸、血糖、血脂、hs-CRP、同型半胱氨酸及五种脂肪细胞因子的差异,采用Logistic回归分析Gensini积分的危险因素和Spearman相关分析脂肪细胞因子与hsCRP、同型半胱氨酸和LDL-c的相关性;利用受试者操作特征(ROC)曲线探讨脂肪细胞因子预测重度冠脉病变的临床效能。结果与对照组比较,CHD患者LDL-c、TC、TG、hs-CRP、尿酸、同型半胱氨酸、内脂素、Chemerin、网膜素-1水平及合并高血压和糖尿病比例均显著高于对照组,而Vaspin和SFRP5水平显著低于对照组,且差异均具有统计学意义(均P <0.05);Logistic回归分析显示,hs-CRP(OR=2.36)、同型半胱氨酸(OR=4.12)、LDL-c(OR=3.45)、内脂素(OR=6.36)、Chemerin(OR=4.69)水平升高是导致Gensini积分升高的危险因素(均P<0.05),而网膜素-1(OR=0.38)、Vaspin(OR=0.49)和SFRP5(OR=0.13)水平升高是导致Gensini积分升高的保护因素(均P <0.05)。CHD患者内脂素、Chemerin水平与hs-CRP、同型半胱氨酸和LDL-c均呈显著正相关性,网膜素-1、Vaspin和SFRP5水平与hs-CRP、同型半胱氨酸和LDL-c均呈显著负相关性。ROC曲线结果发现,内脂素、Chemerin、网膜素-1、Vaspin和SFRP5预测CHD患者冠脉重度病变的预测价值较好。结论 CHD患者脂肪细胞因子内脂素、Chemerin水平升高,与冠状动脉病变程度明显正相关,而网膜素-1、Vaspin和SFRP5水平下降,与冠状动脉病变程度明显负相关。Objective To investigate the association between serum levels of Visfatin,Chemerin,Omenin-1,Vaspin and SFRP5 and coronary artery lesions in patients with coronary heart disease(CHD). Methods A total of 187 patients with CHD and 45 health controls from June 1,2016 to July 1,2018 were retrospectively enrolled in this study. Patients with CHD were divided into mild,moderate and severe lesion groups according to Gensini score. The differences between patients with CHD and control group were evaluated in sex,mean age,BMI,comorbidity of hypertension and diabetes mellitus,uric acid,blood glucose,blood lipid,hs-CRP,homocysteine,Visfatin,Chemerin,Omenin-1,Vaspin and SFRP5. The risk factors of Gensini score and the association between adipocytokines and hs-CRP,homocysteine and LDL-c was analyzed by Logistic regression and Spearman correlation,respectively. The value of adipocytokines in predicting severity of coronary artery lesions in patients with CHD was analyzed by Receiver Operating Characteristic(ROC)curve. Results The serum level of LDL-c,TC,TG,hs-CRP,uric acid,homocysteine,Visfatin,Chemerin,Omenin-1,comorbidity of hypertension and diabetes mellitus were significantly higher in patients than in control group,while the levels of Vaspin and SFRP 5 were significantly lower in patients than in control group(all P < 0.05). Logistic regression analysis showed that the increased levels of hs-CRP(OR = 2.36),homocysteine(OR = 4.12),LDL-c(OR = 3.45),Visfatin(OR = 6.36),Chemerin(OR = 4.69)were the risk factors for the increase of Gensini score(all P < 0.05),while the increased levels of Omenin-1(OR = 0.38),Vaspin(OR = 0.49)and SFRP5(OR = 0.13)were the protective factors(All P < 0.05).The levels of Visfatin and Chemerin were significantly positively correlated with hs-CRP,homocysteine and LDL-c,while the levels of Omenin-1,Vaspin and SFRP5 were significantly negatively correlated with hs-CRP,homocysteine and LDL-c. ROC curve results showed that Visfatin,Chemerin,Omenin-1,Vaspin and SFRP5 were good predictive value in predicting

关 键 词：冠心病 脂肪细胞因子 ROC曲线 冠状动脉病变 老年人 

分 类 号：R541.4[医药卫生—心血管疾病]