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目的评价绝经后女性患者血清抵抗素(Resistin)水平与冠心病病变严重程度的相关性,并探讨抵抗素水平与心血管病危险因素的关系。方法117例绝经后妇女,均检测血清抵抗素、胰岛素,并检测空腹血糖(BG)、超敏C反应蛋白(hs-CRP)、纤维蛋白原(Fib)水平及总胆固醇(TC)、甘油三酯(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)及脂蛋白(a)[Lp(a)]等血脂水平指标。根据冠状动脉病变严重程度分为4组:第1组为冠状动脉无病变者,第2组为冠状动脉轻度病变者,第3组为冠状动脉中度病变者,第4组为冠状动脉重度病变者。有中、重度病变的患者诊断为冠心病。结果冠心病患者血清抵抗素水平显著高于无冠心病的患者[4(1~10)μg/L比2(0~4)μg/L,中位数(四分位数间距)]。多元logistic回归分析显示,血清抵抗素为冠心病独立危险因素(OR1.131;95%CI1.012~1.263)。抵抗素水平与冠状动脉病变程度呈正相关(r=0.231)。控制其他心血管病危险因素后,抵抗素仍然与冠状动脉病变程度呈正相关(r=0.246)。抵抗素水平与患者年龄及hs-CRP呈正相关(r值分别为0.204和0.166,P值分别为0.001及0.009)。结论绝经后妇女血清抵抗素水平可能为冠心病的独立危险因素,并且与冠状动脉病变的严重程度可能存在一定的正相关。由于抵抗素水平与hs-CRP水平呈正相关,故抵抗素可能通过炎症机制影响冠状动脉粥样硬化病变的进程。
Objective To evaluate the relationship between serum resistin (Resistin) levels and the severity of coronary heart disease (CHD) in postmenopausal women and to explore the relationship between resistin levels and cardiovascular risk factors. Methods Serum levels of resistin and insulin were measured in 117 postmenopausal women. Fasting plasma glucose (BG), high sensitivity C-reactive protein (hs-CRP), fibrinogen (Fib) and total cholesterol (TC) TG, HDL-C, LDL-C, ApoA1, ApoB and lipoprotein (a) [Lp (a)] and other indicators of blood lipid levels. According to the severity of coronary artery disease is divided into 4 groups: the first group of patients without coronary lesions, the second group of patients with mild lesions, the third group of patients with moderate coronary lesions, the fourth group of severe coronary artery Lesion. Patients with moderate or severe disease are diagnosed with coronary heart disease. Results The level of serum resistin in patients with coronary heart disease was significantly higher than that in patients without coronary heart disease (median (quartile spacing)) of 4 (1 ~ 10) μg / L vs 2 (0 ~ 4) μg / L. Multivariate logistic regression analysis showed that serum resistin was an independent risk factor for coronary heart disease (OR1.131; 95% CI1.012-1.263). The level of resistin was positively correlated with the severity of coronary artery disease (r = 0.231). After controlling for other cardiovascular risk factors, resistin was still positively correlated with the degree of coronary artery disease (r = 0.246). Resistin levels were positively correlated with patient age and hs-CRP (r = 0.204 and 0.166, P = 0.001 and 0.009, respectively). Conclusions Serum resistin level in postmenopausal women may be an independent risk factor for coronary heart disease and may be positively correlated with the severity of coronary artery disease. Since resistin levels are positively correlated with hs-CRP levels, resistin may affect the course of coronary atherosclerotic lesions through inflammatory mechanisms.