白细胞介素-37和骨保护素与冠状动脉疾病及其严重程度的相关性研究  

Study on the relationship of interleukin-37 and osteoprotegerin with coronary artery disease and its risk degree

作　　者：刘晓辉[1] 孟显达[1] 王中华[1] 张军[1] 韩玉泽[1] 张春雨[1] 梁慧[1] 周杰[2] 刘爱华[3] 吴镝[3] Liu Xiaohui;Meng Xianda;Wang Zhonghua;Zhang Jun;Han Yuze;Zhang Chunyu;Liang Hui;Zhou Jie;Liu Aihua;Wu Di(Department of Cardiovascular Medicine,Dalian Friendship Hospital,Dalian 116001;Department of Laboratory,Dalian Friendship Hospital,Dalian 116001;Department of Radiology,Dalian Friendship Hospital,Dalian 116001)

机构地区：[1]大连市友谊医院心内科,116001 [2]大连市友谊医院检验科,116001 [3]大连市友谊医院放射科,116001

出　　处：《中国医师进修杂志》2021年第12期1067-1071,共5页Chinese Journal of Postgraduates of Medicine

基　　金：2018年大连市医学科学研究计划项目(1811035)。

摘　　要：目的探讨白细胞介素(IL)-37和骨保护素与冠状动脉疾病及其狭窄程度的相关性。方法采用前瞻性的研究方法。选取大连市友谊医院2018年4月至2019年6月211例伴有胸痛或胸闷不适症状的疑似及确诊冠心病患者,均行选择性经皮冠状动脉造影术检查,并完成冠状动脉狭窄程度评分(Gensini评分)。其中,45例冠状动脉狭窄<50%(对照组),52例1支冠状动脉狭窄≥50%(单支病变组),58例2支冠状动脉狭窄≥50%(双支病变组),56例3支冠状动脉狭窄≥50%(三支病变组)。采用全自动生化仪检验空腹血糖(FBG)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)、脂蛋白a、尿酸、肌酐;采用双抗体一步夹心法酶联免疫吸附试验检测IL-37和骨保护素。结果四组FBG、尿酸、肌酐、TC、TG、LDL-C、HDL-C、ApoA1和ApoB比较差异无统计学意义(P>0.05)。对照组、单支病变组、双支病变组、三支病变组脂蛋白a分别为(0.266±0.060)、(0.283±0.070)、(0.289±0.066)和(0.307±0.084)mg/L,冠状动脉狭窄程度评分分别为(8.27±7.08)、(437.45±98.47)、(493.72±125.19)和(522.61±149.34)分,IL-37分别为(342.27±122.36)、(437.45±98.47)、(493.72±125.19)和(522.61±149.34)ng/L,骨保护素分别为(378.29±111.95)、(458.39±115.37)、(502.50±116.88)和(533.39±139.83)ng/L,四组比较差异均有统计学意义(P<0.05或<0.01)。IL-37、骨保护素和脂蛋白a与冠状动脉狭窄程度评分呈正相关(r=0.43、0.42和0.23,P<0.05),骨保护素与IL-37呈正相关(r=0.73,P<0.05)。多元线性回归分析结果显示,IL-37和骨保护素是影响冠状动脉狭窄程度的独立保护因素(β=0.07和0.07,t=2.72和2.57,P<0.01或<0.05),脂蛋白a是影响冠状动脉狭窄程度的独立危险因素(β=0.97,t=2.89,P<0.01)。结论IL-37和骨保护素与冠状动脉狭窄程度呈正相关,两者是冠心病的抗炎保护因素。Objective To investigate the relationship of interleukin(IL)-37,osteoprotegerin with coronary artery disease and its stenosisdegree.Methods The prospective research method was used.From April 2018 to June 2019,two hundred and eleven suspected or diagnosed coronary artery disease patients who had chest pain or discomfort in Dalian Friendship Hospital were selected.The patients underwent selective percutaneous coronary angiography and completed coronary stenosis score(Gensini score).According to the degree of coronary stenosis,211 patients were divided into the control group(coronary stenosis<50%,45 cases),single-vessel stenosis group(single-vessel stenosis≥50%,52 cases),double-vesselstenosis group(double-vesselstenosis≥50%,58 cases),and triple-vessel stenosis group(triple-vessel stenosis≥50%,56 cases).The levels of fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),apolipoprotein A1(ApoA1),apolipoprotein B(ApoB),lipoprotein a,uric acid,creatinine were measured by the automatic biochemical analyzer.The serum levels of IL-37 and osteoprotegerin were detected by enzyme-linked immunosorbent assay.Results There were no statistical differences in FBG,uric acid,creatinine,TC,TG,LDL-C,HDL-C,ApoA1 and ApoB among 4 groups(P>0.05).In the control group,single-vessel stenosis group,double-vessel stenosis group and triple-vessel stenosis group,lipoprotein a was(0.266±0.060),(0.283±0.070),(0.289±0.066)and(0.307±0.084)mg/L respectively;coronary stenosis score was(8.27±7.08),(437.45±98.47),(493.72±125.19)and(522.61±149.34)scores respectively;IL-37 was(342.27±122.36),(437.45±98.47),(493.72±125.19)and(522.61±149.34)ng/L respectively;osteoprotegerin was(378.29±111.95),(458.39±115.37),(502.50±116.88)and(533.39±139.83)ng/L respectively;and there were statistical differences among 4 groups(P<0.05 or<0.01).IL-37,osteoprotegerin and lipoproteina were positively correlated with coronary stenosis score(r=0.43,0.42 and

关 键 词：冠状动脉疾病 白细胞介素类 骨保护素 冠状动脉狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]