血清sCD14、Lp(a)、Gal-3与冠状动脉粥样硬化血管内皮功能及斑块易损性的关系分析  

Analysis of the relationship between serum sCD14,Lp(a),Gal-3 and vascular endothelial function and plaque vulnerability in coronary atherosclerosis

作　　者：桑国耀[1] 王丽娟[1] 张裕祥[2] SANG Guo-yao;WANG Li-juan;ZHANG Yu-xiang(Medical Laboratory Center,the First Affiliated Hospital of Xinjiang Medical University,Urumqi Xinjiang 830000,China;Department of Laboratory,the Sixth Affiliated Hospital of Xinjiang Medical University,Urumqi Xinjiang 830000,China.)

机构地区：[1]新疆医科大学第一附属医院医学检验中心,新疆乌鲁木齐830000 [2]新疆医科大学第六附属医院检验科,新疆乌鲁木齐830000

出　　处：《临床和实验医学杂志》2023年第18期1929-1934,共6页Journal of Clinical and Experimental Medicine

基　　金：新疆维吾尔自治区卫生健康委员会青年医学科技人才专项科研项目(编号:WJWY-XCZX202217)。

摘　　要：目的探讨冠状动脉粥样硬化性心脏病患者血清可溶性白细胞分化抗原(sCD14)、脂蛋白a[Lp(a)]、半乳糖凝集素-3(Gal-3)的变化与内皮功能损伤、斑块易损性的关系。方法回顾性选取2020年4月至2022年4月在新疆医科大学第一附属医院被确诊的100例冠状动脉粥样硬化性心脏病患者作为冠心病组、选取同期因高血压等疾病入住新疆医科大学第一附属医院心血管内科的100例患者作为对照组,对比两组患者的血清sCD14、Lp(a)、Gal-3、一氧化氮(NO)、内皮素-1(ET-1)水平。对两组患者实施冠状动脉CT成像(CTA)检查,其中检测出软斑块患者39例、纤维斑块患者30例、钙化斑块患者31例;对两组患者实施外周动脉反应性充血指数(RHI)检查,发生内皮功能损伤的患者有69例,正常内皮功能31例。根据斑块特征、血管内皮功能损伤情况进行分层分析,分析sCD14、Lp(a)、Gal-3与一氧化氮、ET-1的相关性。结果冠心病组患者的一氧化氮水平低于对照组,sCD14、Lp(a)、Gal-3、ET-1水平高于对照组,差异均有统计学意义(P<0.05)。软斑块患者的一氧化氮水平低于纤维斑块、钙化斑块患者,sCD14、Lp(a)、Gal-3、ET-1水平高于纤维斑块、钙化斑块患者,差异均有统计学意义(P<0.05)。内皮功能损伤患者的一氧化氮水平低于内皮功能正常的冠心病患者,sCD14、ET-1水平均高于内皮功能正常的冠心病患者,差异均有统计学意义(P<0.05)。经线性相关分析,冠心病组患者sCD14与一氧化氮呈显著负相关(P<0.05),与ET-1水平呈显著正相关(P<0.05);冠心病患者的Lp(a)、Gal-3与一氧化氮、ET-1之间无明显的相关性(P>0.05)。结论冠状动脉粥样硬化性心脏病患者一氧化氮水平显著降低,血清sCD14、Lp(a)、Gal-3、ET-1水平显著升高,并且与斑块易损性、血管内皮功能损伤有关。Objective To explore the relationship between the changes of serum soluble leukocyte differentiation antigen(sCD14),lipoprotein a[Lp(a)],galactoagglutinin 3(Gal-3),plaque vulnerability and endothelial function damage in patients with coronary atherosclerotic heart disease.Methods A total of 100 patients with coronary atherosclerotic heart disease diagnosed in the First Affiliated Hospital of Xinjiang Medical University from April 2020 to April 2022 were selected as the coronary heart disease group,and 100 patients admitted to the cardiovascular department of the First Affiliated Hospital of Xinjiang Medical University due to hypertension and other diseases in the same period were selected as the control group.The serum sCD14,Lp(a),Gal-3,nitric oxide,endothelin-1(ET-1)of the two groups of patients were compared.According to CTA observation,there were 39 patients with soft plaque,30 patients with fibrous plaque and 31 patients with calcified plaque.Two groups of patients underwent peripheral arterial reactive congestion index(RHI)examination,with 69 patients experiencing endothelial dysfunction and 31 patients with normal endothelial function.Stratified analysis was performed according to plaque characteristics and vascular endothelial function damage,and the correlation between sCD14,Lp(a),Gal-3 and nitric oxide,ET-1 was analyzed.Results The levels of sCD14,Lp(a),Gal-3 and ET-1 in patients with coronary heart disease were significantly higher than those in the control group and the control group,the differences were statistically significant(P<0.05).The levels of nitric oxide of patients with soft plaque was lower than that of patients with fibrous plaque and coronary heart disease with calcified plaque,and the levels of sCD14,Lp(a),Gal-3 and ET-1 in patients with soft plaque were higher than those in the control group,the differences were statistically significant(P<0.05).The levels of nitric oxide in patients with endothelial dysfunction were lower than those in coronary heart disease patients with normal endoth

关 键 词：冠状动脉粥样硬化性心脏病 可溶性白细胞分化抗原 脂蛋白a 半乳糖凝集素-3 易损性 血管内皮功能 

分 类 号：R541.4[医药卫生—心血管疾病]