老年冠心病患者血清Lp-PLA2、hs-CRP、IL-27及MMP-9水平与Gensini积分的相关性研究
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摘要
目的:探讨老年冠心病患者血清脂蛋白相关磷脂酶A2(Lp-PLA2)、高敏C反应蛋白(hs-CRP)、白细胞介素-27(IL-27)及基质金属蛋白酶-9(MMP-9)水平与Gensini积分的相关性。方法:选取2015年10月至2018年2月我院收治的冠心病患者142例为研究对象,将所有患者按照不同的冠心病类型分为不稳定型心绞痛(UAP)组54例、稳定型心绞痛(SAP)组40例和急性心肌梗死(AMI)组48例。同时根据患者Gensini积分将其分为轻度47例、中度51例和重度44例。比较不同冠心病类型、不同严重程度的Lp-PLA2、hs-CRP、IL-27、MMP-9水平及Gensini积分,并分析冠心病患者上述指标水平与Gensini积分的相关性。结果:AMI组患者Lp-PLA2、hs-CRP、IL-27、MMP-9水平及Gensini积分均高于UAP组和SAP组,且UAP组高于SAP组(P<0.05)。重度患者Lp-PLA2、hs-CRP、IL-27、MMP-9水平及Gensini积分均高于中度和轻度患者,且中度患者高于轻度患者(P<0.05)。经Spearman相关性分析结果显示,冠心病患者Lp-PLA2、hs-CRP、IL-27、MMP-9水平与Gensini积分均呈正相关(P<0.05)。结论:老年冠心病患者Lp-PLA2、hs-CRP、IL-27及MMP-9水平与患者冠状动脉病变Gensini积分均呈正相关。临床根据Lp-PLA2、hs-CRP、IL-27及MMP-9水平的变化,有助于评估老年冠心病患者的病情严重程度。
Objective: To investigate the correlation between serum lipoprotein related phospholipase A2(Lp-PLA2), high sensitive C reactive protein(hs-CRP), interleukin-27(IL-27) and matrix metalloproteinase-9(MMP-9) levels and Gensini score in elderly patients with coronary heart disease. Methods: A total of 142 patient with coronary heart disease, who were treated in Second Affiliated Hospital of Army Medical University from October 2015 to February 2018 were chosen as research subjects and were divided into unstable angina pectoris(UAP) group(n=54), stable angina pectoris(SAP) group(n=40) and acute myocardial infarction(AMI) group(n=48) according to different types of coronary heart disease; meanwhile, the patients were further divided into mild(n=47), moderate(n=51) and severe(n=44) according to the Gensini score. The levels of Lp-PLA2, hs-CRP, IL-27, MMP-9 and Gensini score were compared among different coronary heart disease types and severity, and the correlation between the above indexes levels and Gensini score was analyzed. Results: The levels of Lp-PLA2, hs-CRP, IL-27 and MMP-9 and Gensini score in AMI group were higher than those in UAP group and SAP group, and the UAP group was higher than the SAP group(P<0.05). The levels of Lp-PLA2, hs-CRP, IL-27 and MMP-9 and Gensini score in severe patients were higher than those in moderate and mild patients,and moderate patients were higher than mild patients(P <0.05). The results of Spearman correlation analysis showed that Lp-PLA2, hs-CRP, IL-27 and MMP-9 levels were positively correlated with Gensini score in the patients with coronary heart disease(P <0.05). Conclusion: The levels of Lp-PLA2,hs-CRP, IL-27 and MMP-9 in the elderly patients with coronary heart disease are positively correlated with Gensini score of coronary artery disease, which is helpful to assess the severity of coronary heart disease in elderly patients according in the clinical application.
Objective: To investigate the correlation between serum lipoprotein related phospholipase A2(Lp-PLA2), high sensitive C reactive protein(hs-CRP), interleukin-27(IL-27) and matrix metalloproteinase-9(MMP-9) levels and Gensini score in elderly patients with coronary heart disease. Methods: A total of 142 patient with coronary heart disease, who were treated in Second Affiliated Hospital of Army Medical University from October 2015 to February 2018 were chosen as research subjects and were divided into unstable angina pectoris(UAP) group(n=54), stable angina pectoris(SAP) group(n=40) and acute myocardial infarction(AMI) group(n=48) according to different types of coronary heart disease; meanwhile, the patients were further divided into mild(n=47), moderate(n=51) and severe(n=44) according to the Gensini score. The levels of Lp-PLA2, hs-CRP, IL-27, MMP-9 and Gensini score were compared among different coronary heart disease types and severity, and the correlation between the above indexes levels and Gensini score was analyzed. Results: The levels of Lp-PLA2, hs-CRP, IL-27 and MMP-9 and Gensini score in AMI group were higher than those in UAP group and SAP group, and the UAP group was higher than the SAP group(P<0.05). The levels of Lp-PLA2, hs-CRP, IL-27 and MMP-9 and Gensini score in severe patients were higher than those in moderate and mild patients,and moderate patients were higher than mild patients(P <0.05). The results of Spearman correlation analysis showed that Lp-PLA2, hs-CRP, IL-27 and MMP-9 levels were positively correlated with Gensini score in the patients with coronary heart disease(P <0.05). Conclusion: The levels of Lp-PLA2,hs-CRP, IL-27 and MMP-9 in the elderly patients with coronary heart disease are positively correlated with Gensini score of coronary artery disease, which is helpful to assess the severity of coronary heart disease in elderly patients according in the clinical application.
引文
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[7] Miura K, Saita E, Suzuki-Sugihara N, et al. Plasma interleukin-27levels in patients with coronary artery disease[J]. Medicine(Baltimore), 2017, 96(43):e8260
[8] Zhang Hao, Cheng Jing-lin, Qi Jin-wei, et al. Analysis of Relationshipof hsCRP and Leptin in Patients with Coronary Artery Disease[J].Progress in Modern Biomedicine, 2015, 15(23):4502-4504
[9] Xu Y, Wang Y, Zhi J, et al. Impact of matrix metalloproteinase 9rs3918242 genetic variant on lipid-lowering efficacy of simvastatintherapy in Chinese patients with coronary heart disease[J].BMCPharmacol Toxicol, 2017, 18(1):28
[10] Zhang MM, Chang XW, Hao XQ, et al. Association between matrixmetalloproteinase 9 C-1562T polymorphism and the risk of coronaryartery disease:an update systematic review and meta-analysis[J].Oncotarget, 2017, 9(10):9468-9479
[11]张娜.中西医结合治疗冠心病的临床观察[J].湖北中医药大学学报,2013, 15(6):46-47Zhang Na. Clinical observation of combination of traditional Chineseand Western medicine in the treatment of coronary heart disease[J].Journal of Hubei University of Chinese Medicine, 2013, 15(6):46-47
[12]俞鑫,高扬,戴红艳,等.老年冠脉病变患者肾小球滤过率与Gensini积分相关性[J].贵州医药, 2017, 41(11):1135-1137Yu Xin, Gao Yang, Dai Hong-yan, et al. Association of EstimatedGlomerular Filtration Rate with Gensini Score in Old Patients withCoronary Artery Disease[J]. Guizhou Medical Journal, 2017, 41(11):1135-1137
[13] Xu D, Hu J, Wu Q, et al. Efficacy and safety of Zhibitai incombination with atorvastatin for lipid lowering in patients withcoronary heart disease[J]. Oncotarget, 2017, 9(10):9489-9497
[14] Adams A, Bojara W, Schunk K. Early Diagnosis and Treatment ofCoronary Heart Disease in Asymptomatic Subjects With AdvancedVascular Atherosclerosis of the Carotid Artery(Type III and IV bFindings Using Ultrasound)and Risk Factors[J]. Cardiol Res, 2018, 9(1):22-27
[15] Kim HY, Yong HS, Kim EJ, et al. Value of transluminal attenuationgradient of stress CCTA for diagnosis of haemodynamicallysignificant coronary artery stenosis using wide-area detector CT inpatients with coronary artery disease:comparison with stressperfusion CMR[J]. Cardiovasc J Afr, 2018, 29(1):16-21
[16] Hao Mei-jia, Chen Wen-wei, Wang Dong, et al. Relationship ofSeverity and Ultrasonic Parameters of Carotid Atherosclerosis inPatients with Coronary Heart Disease[J]. Progress in ModernBiomedicine, 2017, 17(12):2275-2278
[17] Bermúdez V, Rojas-Quintero J, Velasco M. The quest forimmunotherapy in atherosclerosis:CANTOS study, interleukin-1βand vascular inflammation[J]. J Thorac Dis, 2018, 10(1):64-69
[18] Hassan M.CANTOS:A breakthrough that proves the inflammatoryhypothesis of atherosclerosis[J]. Glob Cardiol Sci Pract, 2018, 2018(1):2
[19] Yang L, Liu Y, Wang S, et al. Association between Lp-PLA2 andcoronary heart disease in Chinese patients[J]. J Int Med Res, 2017, 45(1):159-169
[20] Wang C, Fang X, Hua Y, et al. Lipoprotein-Associated PhospholipaseA2 and Risk of Carotid Atherosclerosis and Cardiovascular Events inCommunity-Based Older Adults in China[J]. Angiology, 2018, 69(1):49-58
[21] Zheng Di, Fu Rui-xue, Li Wen-hua, et al. Association of LP-PLA2and AT-Ⅲwith the severity of coronary artery in patients withcoronary disease:a cross-sectional analysis[J]. The Journal ofPractical Medicine, 2017, 33(16):2721-2724
[22] Hou D, Liu J, Feng R, et al. The role of high-sensitivity C-reactiveprotein levels in functional outcomes in patients with large-arteryatherosclerosis and small-artery occlusion[J]. Neurol Res, 2017, 39(11):981-987
[23] Seyedian SM, Ahmadi F, Dabagh R, et al. Relationship betweenhigh-sensitivity C-reactive protein serum levels and the severity ofcoronary artery stenosis in patients with coronary artery disease[J].ARYA Atheroscler, 2016, 12(5):231-237
[24] Gregersen I, Sandanger ?, Askevold ET, et al. Interleukin 27 isincreased in carotid atherosclerosis and promotes NLRP3inflammasome activation[J]. PLoS One, 2017, 12(11):e0188387
[25] Vaidya K, Arnott C, Martínez GJ, et al. Colchicine Therapy andPlaque Stabilization in Patients With Acute Coronary Syndrome:ACT Coronary Angiography Study[J]. JACC Cardiovasc Imaging,2018,11(2 Pt 2):305-316
[26] Lekic A, Brekalo Z, Kvesic A. Crosstalk Between Enzyme MatrixMetalloproteinases 2 and 9 and Regulatory T Cell Immunity in theGlobal Burden of Atherosclerosis[J]. Scand J Immunol, 2017, 86(1):65-71
[27] Beton O, Arslan S, Acar B, et al. Association between MMP-3 andMMP-9 polymorphisms and coronary artery disease[J]. Biomed Rep,2016, 5(6):709-714
[28]范珊,安园园,周韵,等.低骨密度和冠心病Gensini积分的相关性[J].中国组织工程研究, 2015, 19(51):8213-8217Fan Shan, An Yuan-yuan, Zhou Yun, et al. Association between lowbone mineral density and Gensini integral in patients with coronaryartery disease[J]. Journal of Clinical Rehabilitative TissueEngineering Research, 2015, 19(51):8213-8217
[2] Séguro F, Rabès JP, Taraszkiewicz D, et al. Genetic diagnosis offamilial hypercholesterolemia is associated with a premature and highcoronary heart disease risk[J]. Clin Cardiol, 2018, 41(3):385-391
[3] Posadas-Sánchez R, Vargas-Alarcón G. Innate Immunity in CoronaryDisease. The Role of Interleukin-12 Cytokine Family inAtherosclerosis[J]. Rev Invest Clin, 2018, 70(1):5-17
[4] Sairam SG, Sola S, Barooah A, et al. The role of Lp-PLA andbiochemistry parameters as potential biomarkers of coronary arterydisease in Asian South-Indians:a case-control study[J]. CardiovascDiagn Ther, 2017, 7(6):589-597
[5] Pokharel Y, Sun W, Polfus LM, et al. Lipoprotein associatedphospholipase A2 activity, apolipoprotein C3 loss-of-functionvariants and cardiovascular disease:The Atherosclerosis Risk InCommunities Study[J]. Atherosclerosis, 2015, 241(2):641-648
[6] Raygan F, Bahmani F, Kouchaki E, et al. Comparative effects ofcarbohydrate versus fat restriction on metabolic profiles, biomarkersof inflammation and oxidative stress in overweight patients with Type2 diabetic and coronary heart disease:A randomized clinical trial[J].ARYA Atheroscler, 2016, 12(6):266-273
[7] Miura K, Saita E, Suzuki-Sugihara N, et al. Plasma interleukin-27levels in patients with coronary artery disease[J]. Medicine(Baltimore), 2017, 96(43):e8260
[8] Zhang Hao, Cheng Jing-lin, Qi Jin-wei, et al. Analysis of Relationshipof hsCRP and Leptin in Patients with Coronary Artery Disease[J].Progress in Modern Biomedicine, 2015, 15(23):4502-4504
[9] Xu Y, Wang Y, Zhi J, et al. Impact of matrix metalloproteinase 9rs3918242 genetic variant on lipid-lowering efficacy of simvastatintherapy in Chinese patients with coronary heart disease[J].BMCPharmacol Toxicol, 2017, 18(1):28
[10] Zhang MM, Chang XW, Hao XQ, et al. Association between matrixmetalloproteinase 9 C-1562T polymorphism and the risk of coronaryartery disease:an update systematic review and meta-analysis[J].Oncotarget, 2017, 9(10):9468-9479
[11]张娜.中西医结合治疗冠心病的临床观察[J].湖北中医药大学学报,2013, 15(6):46-47Zhang Na. Clinical observation of combination of traditional Chineseand Western medicine in the treatment of coronary heart disease[J].Journal of Hubei University of Chinese Medicine, 2013, 15(6):46-47
[12]俞鑫,高扬,戴红艳,等.老年冠脉病变患者肾小球滤过率与Gensini积分相关性[J].贵州医药, 2017, 41(11):1135-1137Yu Xin, Gao Yang, Dai Hong-yan, et al. Association of EstimatedGlomerular Filtration Rate with Gensini Score in Old Patients withCoronary Artery Disease[J]. Guizhou Medical Journal, 2017, 41(11):1135-1137
[13] Xu D, Hu J, Wu Q, et al. Efficacy and safety of Zhibitai incombination with atorvastatin for lipid lowering in patients withcoronary heart disease[J]. Oncotarget, 2017, 9(10):9489-9497
[14] Adams A, Bojara W, Schunk K. Early Diagnosis and Treatment ofCoronary Heart Disease in Asymptomatic Subjects With AdvancedVascular Atherosclerosis of the Carotid Artery(Type III and IV bFindings Using Ultrasound)and Risk Factors[J]. Cardiol Res, 2018, 9(1):22-27
[15] Kim HY, Yong HS, Kim EJ, et al. Value of transluminal attenuationgradient of stress CCTA for diagnosis of haemodynamicallysignificant coronary artery stenosis using wide-area detector CT inpatients with coronary artery disease:comparison with stressperfusion CMR[J]. Cardiovasc J Afr, 2018, 29(1):16-21
[16] Hao Mei-jia, Chen Wen-wei, Wang Dong, et al. Relationship ofSeverity and Ultrasonic Parameters of Carotid Atherosclerosis inPatients with Coronary Heart Disease[J]. Progress in ModernBiomedicine, 2017, 17(12):2275-2278
[17] Bermúdez V, Rojas-Quintero J, Velasco M. The quest forimmunotherapy in atherosclerosis:CANTOS study, interleukin-1βand vascular inflammation[J]. J Thorac Dis, 2018, 10(1):64-69
[18] Hassan M.CANTOS:A breakthrough that proves the inflammatoryhypothesis of atherosclerosis[J]. Glob Cardiol Sci Pract, 2018, 2018(1):2
[19] Yang L, Liu Y, Wang S, et al. Association between Lp-PLA2 andcoronary heart disease in Chinese patients[J]. J Int Med Res, 2017, 45(1):159-169
[20] Wang C, Fang X, Hua Y, et al. Lipoprotein-Associated PhospholipaseA2 and Risk of Carotid Atherosclerosis and Cardiovascular Events inCommunity-Based Older Adults in China[J]. Angiology, 2018, 69(1):49-58
[21] Zheng Di, Fu Rui-xue, Li Wen-hua, et al. Association of LP-PLA2and AT-Ⅲwith the severity of coronary artery in patients withcoronary disease:a cross-sectional analysis[J]. The Journal ofPractical Medicine, 2017, 33(16):2721-2724
[22] Hou D, Liu J, Feng R, et al. The role of high-sensitivity C-reactiveprotein levels in functional outcomes in patients with large-arteryatherosclerosis and small-artery occlusion[J]. Neurol Res, 2017, 39(11):981-987
[23] Seyedian SM, Ahmadi F, Dabagh R, et al. Relationship betweenhigh-sensitivity C-reactive protein serum levels and the severity ofcoronary artery stenosis in patients with coronary artery disease[J].ARYA Atheroscler, 2016, 12(5):231-237
[24] Gregersen I, Sandanger ?, Askevold ET, et al. Interleukin 27 isincreased in carotid atherosclerosis and promotes NLRP3inflammasome activation[J]. PLoS One, 2017, 12(11):e0188387
[25] Vaidya K, Arnott C, Martínez GJ, et al. Colchicine Therapy andPlaque Stabilization in Patients With Acute Coronary Syndrome:ACT Coronary Angiography Study[J]. JACC Cardiovasc Imaging,2018,11(2 Pt 2):305-316
[26] Lekic A, Brekalo Z, Kvesic A. Crosstalk Between Enzyme MatrixMetalloproteinases 2 and 9 and Regulatory T Cell Immunity in theGlobal Burden of Atherosclerosis[J]. Scand J Immunol, 2017, 86(1):65-71
[27] Beton O, Arslan S, Acar B, et al. Association between MMP-3 andMMP-9 polymorphisms and coronary artery disease[J]. Biomed Rep,2016, 5(6):709-714
[28]范珊,安园园,周韵,等.低骨密度和冠心病Gensini积分的相关性[J].中国组织工程研究, 2015, 19(51):8213-8217Fan Shan, An Yuan-yuan, Zhou Yun, et al. Association between lowbone mineral density and Gensini integral in patients with coronaryartery disease[J]. Journal of Clinical Rehabilitative TissueEngineering Research, 2015, 19(51):8213-8217