冠心病患者血清RBP4、hs-CRP、IL-6水平检测的临床意义
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摘要
目的探讨冠心病(CHD)患者血清视黄醇结合蛋白4(RBP4)、高敏C反应蛋白(hsCRP)、白细胞介素-6(IL-6)水平检测的临床意义。方法选择内江市第一人民医院心内科于2017年1月至2018年1月就诊的CHD患者142例作为研究对象,另选取同期体检健康人50例作为对照组,比较两组患者血清hs-CRP、IL-6和RBP4水平,并分析CHD患者血清hs-CRP、IL-6和RBP4与冠心病病变程度的相关性。结果心肌梗死组、不稳定型心绞痛组、稳定型心绞痛组血清hs-CRP、IL-6、BRP4水平显著高于对照组,心肌梗死组、不稳定型心绞痛组血清hs-CRP、IL-6、BRP4水平显著高于稳定型心绞痛组(P<0.05)。随病变支数及病变程度增加冠心病患者血清hs-CRP、IL-6、BRP4水平逐渐升高,不同病变支数及病变程度冠心病患者血清hs-CRP、IL-6、BRP4水平有统计学差异(P<0.05)。Pearson相关性分析显示,CHD组患者的血清RBP4与hs-CRP、IL-6表达呈正相关(r=0.476,0.584,P<0.05);血清RBP4、hs-CRP、IL-6与Gensini积分呈正相关(r=0.672,0.574,0.465,P<0.05)。结论血清RBP4、hs-CRP、IL-6水平升高可以反应CHD患者冠状动脉病变范围及狭窄程度。
Objective To investigate the clinical significance of detecting serum retinol binding protein 4(RBP4),high-sensitivity C-reactive protein(hs-CRP) and interleukin-6(IL-6) in patients with coronary heart disease(CHD).Methods A total of 142 patients with CHD in the First People's Hospital of Neijiang from January 2017 to January2018 were enrolled in the study. Another 50 healthy subjects were selected as the control group. The serum levels of hs-CRP, IL-6 and RBP4 were compared. The correlation between serum hs-CRP, IL-6 and RBP4 in patients with CHD and coronary heart disease was analyzed. Results The serum level of hs-CRP, IL-6 and BRP4 in myocardial infarction group, unstable angina pectoris group and stable angina pectoris group was significantly higher than that in control group. The serum level of hs-CRP, IL-6 and BRP4 in the myocardial infarction group and the unstable angina pectoris group was significantly higher than that in the stable angina pectoris group(P<0.05). The serum level of hsCRP, IL-6 and BRP4 in patients with coronary heart disease increased gradually with the increase of the number of lesions and the degree of lesions, there was significant difference in the serum level of hs-CRP, IL-6 and BRP4 in patients with coronary heart disease with different lesions and the degree of lesions(P<0.05). Pearson correlation analysis showed that serum RBP4 was positively correlated with the expression of hs-CRP and IL-6 in CHD patients(r=0.476, 0.584, P<0.05), and the serum RBP4, hs-CRP, IL-6 was positively correlated with the Gensini score(r=0.672,0.574, 0.465, P<0.05). Conclusion The elevated levels of RBP4, hs-CRP and IL-6 can reflect the extent and stenosis of coronary artery disease in CHD patients.
Objective To investigate the clinical significance of detecting serum retinol binding protein 4(RBP4),high-sensitivity C-reactive protein(hs-CRP) and interleukin-6(IL-6) in patients with coronary heart disease(CHD).Methods A total of 142 patients with CHD in the First People's Hospital of Neijiang from January 2017 to January2018 were enrolled in the study. Another 50 healthy subjects were selected as the control group. The serum levels of hs-CRP, IL-6 and RBP4 were compared. The correlation between serum hs-CRP, IL-6 and RBP4 in patients with CHD and coronary heart disease was analyzed. Results The serum level of hs-CRP, IL-6 and BRP4 in myocardial infarction group, unstable angina pectoris group and stable angina pectoris group was significantly higher than that in control group. The serum level of hs-CRP, IL-6 and BRP4 in the myocardial infarction group and the unstable angina pectoris group was significantly higher than that in the stable angina pectoris group(P<0.05). The serum level of hsCRP, IL-6 and BRP4 in patients with coronary heart disease increased gradually with the increase of the number of lesions and the degree of lesions, there was significant difference in the serum level of hs-CRP, IL-6 and BRP4 in patients with coronary heart disease with different lesions and the degree of lesions(P<0.05). Pearson correlation analysis showed that serum RBP4 was positively correlated with the expression of hs-CRP and IL-6 in CHD patients(r=0.476, 0.584, P<0.05), and the serum RBP4, hs-CRP, IL-6 was positively correlated with the Gensini score(r=0.672,0.574, 0.465, P<0.05). Conclusion The elevated levels of RBP4, hs-CRP and IL-6 can reflect the extent and stenosis of coronary artery disease in CHD patients.
引文
[1]毕进.盐酸曲美他嗪治疗冠心病稳定型心绞痛的临床治疗疗效[J].中国医药指南,2018,16(6):93.
[2]Sun Q,Kiernan UA,Shi L,et al.Plasma retinol-binding protein 4(RBP4)levels and risk of coronary heart disease:a prospective analysis among women in the nurses'health study[J].Circulation,2013,127(19):1938-47.
[3]赵明.冠心病患者血清hs-CRP、cTnI和血脂水平变化及其临床意义[J].大医生,2017,2(7):110,153.
[4]武春艳.冠心病慢性心力衰竭患者血清PCSK9水平的变化及其临床意义[J].中国当代医药,2017,24(13):38-40,44.
[5]陈珊珊,陈巧红,李心德.高血压、冠心病患者血清同型半胱氨酸和超敏C反应蛋白水平的变化及临床意义[J].海南医学,2017,28(05):769-71.
[6]Moraes-Vieira PM,Castoldi A,Aryal P,et al.Antigen Presentation and T-Cell Activation Are Critical for RBP4-Induced Insulin Resistance[J].Diabetes,2016,65(5):1317-27.
[7]沈卫峰,张奇,张瑞岩.2015年急性ST段抬高型心肌梗死诊断和治疗指南解析[J].国际心血管病杂志,2015,42(4):217-9.
[8]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.非ST段抬高型急性冠状动脉综合征诊断和治疗指南(2016)[J].中华心血管病杂志,2017,45(5):359-76.
[9]慢性稳定性心绞痛诊断与治疗指南[J].中华心血管病杂志,2007,35(3):195-206.
[10]周芳.冠心病患者血清超敏C反应蛋白、肌钙蛋白与血脂水平变化及临床意义[J].临床医学研究与实践,2016,1(6):1-2.
[11]徐红,谭海明.冠心病患者血清脂蛋白(a)水平变化及其临床意义[J].世界最新医学信息文摘,2016,16(98):9-10.
[12]吴桂平,付鑫,张彦红,等.冠心病患者炎性因子的变化及其与血清视黄醇结合蛋白4水平的相关性研究[J].中国医药指南,2014,12(5):7-8.
[13]李宇林,彭军,文俊杰,等.血清超敏C-反应蛋白、视黄醇结合蛋白4及血浆结合珠蛋白水平在冠心病患者中的变化及其意义[J].中华老年多器官疾病杂志,2017,16(11):850-3.
[14]Wan K,Zhao J,Deng Y,et al.A genetic polymorphism in RBP4 is associated with coronary artery disease[J].Int J Mol Sci,2014,15(12):22309-19.
[15]刘妍,李勤学.血清视黄醇结合蛋白4在糖尿病大血管病变的研究进展[J].内蒙古医学杂志,2016,48(6):708-10.
[16]张敏,陈树,陈平,等.吡格列酮对Ⅱ型糖尿病并发冠心病患者血清视黄醇结合蛋白4的影响[J].西部医学,2014,26(03):320-2.
[17]Yu M,Ishibashi-Ueda H,Ohta-Ogo K,et al.Transient expression of cellular retinol-binding protein-1 during cardiac repair after myocardial infarction[J].Pathol Int,2012,62(4):246-53.
[18]Prentice RL,Paczesny S,Aragaki A,et al.Novel proteins associated with risk for coronary heart disease or stroke among postmenopausal women identified by in-depth plasma proteome profiling[J].Genome Med,2010,2(7):48.
[19]Lee SA,Yuen JJ,Jiang H,et al.Adipocyte-specific overexpression of retinol-binding protein 4 causes hepatic steatosis in mice[J].Hepatol ogy,2016,64(5):1534-46.
[2]Sun Q,Kiernan UA,Shi L,et al.Plasma retinol-binding protein 4(RBP4)levels and risk of coronary heart disease:a prospective analysis among women in the nurses'health study[J].Circulation,2013,127(19):1938-47.
[3]赵明.冠心病患者血清hs-CRP、cTnI和血脂水平变化及其临床意义[J].大医生,2017,2(7):110,153.
[4]武春艳.冠心病慢性心力衰竭患者血清PCSK9水平的变化及其临床意义[J].中国当代医药,2017,24(13):38-40,44.
[5]陈珊珊,陈巧红,李心德.高血压、冠心病患者血清同型半胱氨酸和超敏C反应蛋白水平的变化及临床意义[J].海南医学,2017,28(05):769-71.
[6]Moraes-Vieira PM,Castoldi A,Aryal P,et al.Antigen Presentation and T-Cell Activation Are Critical for RBP4-Induced Insulin Resistance[J].Diabetes,2016,65(5):1317-27.
[7]沈卫峰,张奇,张瑞岩.2015年急性ST段抬高型心肌梗死诊断和治疗指南解析[J].国际心血管病杂志,2015,42(4):217-9.
[8]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.非ST段抬高型急性冠状动脉综合征诊断和治疗指南(2016)[J].中华心血管病杂志,2017,45(5):359-76.
[9]慢性稳定性心绞痛诊断与治疗指南[J].中华心血管病杂志,2007,35(3):195-206.
[10]周芳.冠心病患者血清超敏C反应蛋白、肌钙蛋白与血脂水平变化及临床意义[J].临床医学研究与实践,2016,1(6):1-2.
[11]徐红,谭海明.冠心病患者血清脂蛋白(a)水平变化及其临床意义[J].世界最新医学信息文摘,2016,16(98):9-10.
[12]吴桂平,付鑫,张彦红,等.冠心病患者炎性因子的变化及其与血清视黄醇结合蛋白4水平的相关性研究[J].中国医药指南,2014,12(5):7-8.
[13]李宇林,彭军,文俊杰,等.血清超敏C-反应蛋白、视黄醇结合蛋白4及血浆结合珠蛋白水平在冠心病患者中的变化及其意义[J].中华老年多器官疾病杂志,2017,16(11):850-3.
[14]Wan K,Zhao J,Deng Y,et al.A genetic polymorphism in RBP4 is associated with coronary artery disease[J].Int J Mol Sci,2014,15(12):22309-19.
[15]刘妍,李勤学.血清视黄醇结合蛋白4在糖尿病大血管病变的研究进展[J].内蒙古医学杂志,2016,48(6):708-10.
[16]张敏,陈树,陈平,等.吡格列酮对Ⅱ型糖尿病并发冠心病患者血清视黄醇结合蛋白4的影响[J].西部医学,2014,26(03):320-2.
[17]Yu M,Ishibashi-Ueda H,Ohta-Ogo K,et al.Transient expression of cellular retinol-binding protein-1 during cardiac repair after myocardial infarction[J].Pathol Int,2012,62(4):246-53.
[18]Prentice RL,Paczesny S,Aragaki A,et al.Novel proteins associated with risk for coronary heart disease or stroke among postmenopausal women identified by in-depth plasma proteome profiling[J].Genome Med,2010,2(7):48.
[19]Lee SA,Yuen JJ,Jiang H,et al.Adipocyte-specific overexpression of retinol-binding protein 4 causes hepatic steatosis in mice[J].Hepatol ogy,2016,64(5):1534-46.