冠心病患者血清RBP4、CysC水平与肠道菌群的关系  

The relationship among serum RBP4,CysC levels and intestinal flora in patients with coronary heart disease

作　　者：孙贤辉 孙小清 张虹 谭成燕 周秀 SUN Xian-hui;SUN Xiao-qing;ZHANG Hong;TAN Cheng-yan;ZHOU Xiu(Department of Emergency,Chongqing Jiangbei District Hospital of Traditional Chinese Medicine,Chongqing,400020,China)

机构地区：[1]重庆市江北区中医院急诊科,重庆400020 [2]重庆市第五人民医院 [3]重庆市开州区人民医院 [4]重庆市江北区第二人民医院(重庆市江北区精神卫生中心)

出　　处：《心血管康复医学杂志》2024年第4期401-406,共6页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：2024年重庆市科卫联合中医药科研项目(2024ZYYB008)。

摘　　要：目的:探讨冠心病患者血清视黄醇结合蛋白4(RBP4)、胱抑素C(CysC)的水平及其与肠道菌群的关系。方法:选择2019年12月至2020年12月在我院重症医学科就诊的97例冠心病患者作为冠心病组,99名同期健康体检者作为对照组。比较两组血清RBP4、CysC水平及肠道菌群阳性率及数量。以冠心病患者血清RBP4、CysC平均水平为界,将其分为血清RBP4高水平组(RBP4≥35.97 ng/ml)53例和低水平组(RBP4<35.97 ng/ml)44例,血清CysC高水平组(CysC≥1.49 ng/ml)49例和低水平组(CysC<1.49 ng/ml)48例。比较不同水平组菌群数量,采用Pearson法分析RBP4、CysC水平与菌群数量的相关性。结果:与对照组比较,冠心病组RBP4、CysC水平均显著升高,双歧杆菌属、厚壁菌、乳酸杆菌属、变形杆菌的培养阳性率及菌群数量均显著降低(P均<0.001),葡萄球菌、大肠埃希菌的培养阳性率及菌群数量均显著升高(P均<0.001)。与RBP4低水平组比较,RBP4高水平组双歧杆菌、厚壁菌、乳酸杆菌、变形杆菌数量均显著减少,葡萄球菌、大肠埃希菌数量显著增加(P均<0.001);与CysC低水平组比较,CysC高水平组双歧杆菌、厚壁菌、乳酸杆菌、变形杆菌数量显著减少,葡萄球菌、大肠埃希菌数量显著增加(P均<0.001)。Pearson相关分析显示,RBP4水平与双歧杆菌属、厚壁菌、乳酸杆菌属、变形杆菌数量呈显著负相关(r=-0.626~-0.482,P均<0.001),与葡萄球菌、大肠埃希菌数量显著正相关(r=0.302、0.337,P均<0.01);CysC水平与双歧杆菌属、厚壁菌、乳酸杆菌属、变形杆菌数量呈显著负相关(r=-0.621~-0.502,P均<0.001),与葡萄球菌、大肠埃希菌数量呈显著正相关(r=0.308、0.340,P均<0.01)。结论:冠心病患者血清RBP4、CysC水平升高,且与肠道菌群组成密切相关。Objective:To investigate serum levels of retinol-binding protein 4(RBP4)and cystatin C(CysC)in patients with coronary heart disease(CHD)and their association with intestinal flora.Methods:A total of 97 CHD patients admitted in our Department of Critical Care Medicine from December 2019 to December 2020 were treated as CHD group,another 99 healthy subjects undergoing physical examination simultaneously were regarded as control group.Serum levels of RBP4 and CysC,positive rates and number of intestinal flora were compared between two groups.With serum mean levels of RBP4 and CysC in CHD patients as critical value,they were divided into serum RBP4 high level group(RBP4≥35.97 ng/ml,n=53)and low level group(RBP4<35.97 ng/ml,n=44),serum CysC high level group(CysC≥1.49 ng/ml,n=49)and low level group(CysC<1.49 ng/ml,n=48).Number of intestinal flora were compared between different level subgroups,and Pearson method was used to analyze the association of RBP4,CysC levels with flora number.Results:Compared with control group,there were significant rise in RBP4 and CysC levels,and significant reductions in culture positive rates and flora numbers of Bifidobacterium,Firmicutes,Lactobacillus and Proteus(P<0.001 all),and significant rise in culture positive rates and flora numbers of Staphylococcus and Escherichia coli in CHD group(P<0.001 all).Compared with RBP4 low level group,there were significant reductions in flora numbers of Bifidobacterium,Firmicutes,Lactobacillus and Proteus,and significant rise in flora numbers of Staphylococcus and Escherichia coli in RBP4 high level group(P<0.001 all);compared with CysC low level group,there were significant reductions in flora numbers of Bifidobacterium,Firmicutes,Lactobacillus and Proteus,and significant rise in flora numbers of Staphylococcus and Escherichia coli in CysC high level group(P<0.001 all).Pearson correlation analysis indicated that RBP4 level was significant inversely correlated with flora numbers of Bifidobacterium,Firmicutes,Lactobacillus and Proteus(r=-0.626~-0

关 键 词：心脏病 视黄醇结合蛋白4 半胱氨酸蛋白酶抑制剂 肠杆菌科 

分 类 号：R541[医药卫生—心血管疾病]