不稳定型心绞痛患者血清血管生成素样蛋白2水平变化及临床意义
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摘要
目的探讨不稳定型心绞痛(UAP)患者血清血管生成素样蛋白2(Angptls 2)水平的变化及临床意义。方法选取2016年3—12月住院治疗的胸痛待查患者127例,根据冠状动脉造影结果分为UAP组(n=92)和对照组(n=35);根据冠状动脉病变支数将UAP患者分成单支病变组(n=29)、双支病变组(n=48)和多支病变组(n=15);根据冠状动脉狭窄程度将UAP患者分成轻度闭塞组(n=26)、中度闭塞组(n=27)、重度闭塞组(n=26)和完全闭塞组(n=13)。采用免疫吸附试验(ELISA法)检测血清Angptls 2水平。结果与对照组比较,UAP组体质量指数(BMI)、总胆固醇(TC)、低密度总蛋白-C(LDL-C)、超敏C-反应蛋白(hs-CRP)、血肌酐(Scr)、同型半胱氨酸(Hcy)和Angptls 2水平均升高,差别均有统计学意义(P<0.05);多支病变组患者血清Angptls 2水平高于双支病变组和单支病变组,且双支病变组高于单支病变组,差别均有统计学意义(P<0.05);血清Angptls 2水平比较:完全闭塞组>重度闭塞组>中度闭塞组>轻度闭塞组,差别均有统计学意义(P<0.05);多重线性回归分析结果显示,hs-CRP,LDL-C及冠状动脉狭窄度≥76%、Gensini评分与UAP患者血清Angptls 2水平相关(偏回归系数=0.033,0.004,6.219和4.830,P<0.05)。结论 UAP患者血清Angptls 2水平升高,且与冠状动脉病变支数和狭窄程度有关,可作为反映冠状动脉病变严重程度的指标。
Objective To investigate the changes of serum angiopoietin-2 in patients with unstable angina pectoris(UAP) and its clinical significance. Methods 127 cases of patients with chest pain undergoing treatment in our hospital were selected from March to December 2016. Based on the results of coronary angiography, patients were divided into UAP group(n=92) and control group(n=35). Based on the number of coronary artery lesions, UAP patients were divided into single vessel lesion group(n=29), double vessel lesion group(n=48) and multivessel lesion group(n=15). Based on the degree of coronary artery stenosis, UAP patients were divided into mild occlusion group(n=26), moderate occlusion group(n=27), severe occlusion group(n=26), and complete occlusion group(n=13). The clinical data was collected. The serum levels of Angptls 2 were measured by immunoadsorption assay(ELISA). Results Compared with the control group, the body mass index(BMI), total cholesterol(TC), low density total protein-C(LDL-C), hypersensitive C-reactive protein(hs-CRP), serum creatinine(Scr), homocysteine(Hcy), and angiopoietin-2(Angptls 2) were increased in UAP group, the differences were statistically significant(P<0.05). The serum level of Angptls 2 in multivessel lesion group was higher than the double vessel lesion group and single vessel lesion group, while the double vessel lesion group was higher than the single vessel lesion group, and the differences were statistically significant(P<0.05). The serum level of Angptls 2: complete occlusion group>severe occlusion group>moderate occlusion group>mild occlusion group, and the differences were statistically significant(P<0.05). The results of multiple linear regression analysis showed hs-CRP, LDL-C, coronary artery stenosis ≥76% and Gensini score were correlated with serum level of Angptls 2 in UAP patients(Partial regression coefficients=0.033, 0.004, 6.219 and 4.830, P<0.05). Conclusion The serum level of Angptls 2 in UAP patients is elevated, and is correlated with the number of coronary artery lesions and the degree of coronary artery stenosis. It may be used as an indicator for reflecting the severity of coronary artery disease in the patients.
Objective To investigate the changes of serum angiopoietin-2 in patients with unstable angina pectoris(UAP) and its clinical significance. Methods 127 cases of patients with chest pain undergoing treatment in our hospital were selected from March to December 2016. Based on the results of coronary angiography, patients were divided into UAP group(n=92) and control group(n=35). Based on the number of coronary artery lesions, UAP patients were divided into single vessel lesion group(n=29), double vessel lesion group(n=48) and multivessel lesion group(n=15). Based on the degree of coronary artery stenosis, UAP patients were divided into mild occlusion group(n=26), moderate occlusion group(n=27), severe occlusion group(n=26), and complete occlusion group(n=13). The clinical data was collected. The serum levels of Angptls 2 were measured by immunoadsorption assay(ELISA). Results Compared with the control group, the body mass index(BMI), total cholesterol(TC), low density total protein-C(LDL-C), hypersensitive C-reactive protein(hs-CRP), serum creatinine(Scr), homocysteine(Hcy), and angiopoietin-2(Angptls 2) were increased in UAP group, the differences were statistically significant(P<0.05). The serum level of Angptls 2 in multivessel lesion group was higher than the double vessel lesion group and single vessel lesion group, while the double vessel lesion group was higher than the single vessel lesion group, and the differences were statistically significant(P<0.05). The serum level of Angptls 2: complete occlusion group>severe occlusion group>moderate occlusion group>mild occlusion group, and the differences were statistically significant(P<0.05). The results of multiple linear regression analysis showed hs-CRP, LDL-C, coronary artery stenosis ≥76% and Gensini score were correlated with serum level of Angptls 2 in UAP patients(Partial regression coefficients=0.033, 0.004, 6.219 and 4.830, P<0.05). Conclusion The serum level of Angptls 2 in UAP patients is elevated, and is correlated with the number of coronary artery lesions and the degree of coronary artery stenosis. It may be used as an indicator for reflecting the severity of coronary artery disease in the patients.
引文
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[13] 杨洪强,朱杰,王中群,等. 血管生成素样蛋白2促进ApoE-/-小鼠动脉粥样硬化内膜钙化[J]. 中国动脉硬化杂志,2015,23(8):757-762.
[14] Horio E, Kadomatsu T, Miyata K, et al. Role of endothelial cell-derived Angptl 2 in vascular inflammation leading to endothelial dysfunction and atherosclerosis progression[J]. Arterioscler Thromb Vasc Biol,2014,34(4):790-800.
[15] 王树源,黄家卓,赵东华. Angptl 2联合hs-CRP检测在早期诊断急性冠脉综合征中的意义[J]. 中国医药科学,2017,7(2):166-168.
[2] Zhao K,Xu X S,Meng X,et al. Autophagy of monocytes attenuates the vulnerability of coronary atherosclerotic plaques[J]. Coron Artery Dis,2013,24(8):651-656.
[3] Chong H C,Chan J S,Goh C Q,et al. Angiopoietin-like 4 stimulates STAT3-mediated iNOS expression and enhances angiogenesis to accelerate wound healing in diabetic mice[J]. Mol Ther,2014,22(9):1593-1604.
[4] 李晓丽,谭华清,唐湘宇. 血管生成素样蛋白2与冠心病的研究进展[J]. 中国心血管病研究,2017,15(4):298-301.
[5] Horio E,Kadomatsu T,Miyata K,et al. Role of endothelial cell-derived Angptl 2 in vascular inflammation leading to endothelial dysfunction and atherosclerosis progression[J]. Arterioscler Thromb Vasc Biol,2014,34(4):790-800.
[6] 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. 不稳定性心绞痛和非ST段抬高心肌梗死诊断与治疗指南[J]. 中华心血管病杂志,2007,35(4):295-304.
[7] Kashani H,Zeraati H,Mohammad K,et al. Analyzing Gensini score as a semi-continuous outcome[J]. J Tehran Heart Cent,2016,11(2):55-61.
[8] Dong L,Mintz G S,Witzenbichler B,et al. Comparison of plaque characteristics in narrowings with ST-elevation myocardial infarction (STEMI), non-STEMI/unstable angina pectoris and stable coronary artery disease (from the ADAPT-DES IVUS Substudy)[J]. Am J Cardiol, 2015,115(7):860-866.
[9] Alkamel A,Shafiee A,Jalali A,et al. The association between premature coronary artery disease and level of testosterone in young adult males[J]. Arch Iran Med, 2014, 17(8):545-550.
[10] 张琼. 生物标志物对急性冠状动脉综合征的诊断价值研究进展[J]. 心血管病学进展,2015,36(3):328-331.
[11] Johari Moghadam A,Azizinejad S. Study of high sensitive C-reactive protein (hs-CRP) after cardiac rehabilitation program in patients undergoing isolated CABG[J]. Int J Biomed Sci, 2016, 12(4):143-148.
[12] Sato R,Yamasaki M,Hirai K,et al. Angiopoietin-like protein 2 induces androgen-independent and malignant behavior in human prostate cancer cells[J]. Oncol Rep, 2015, 33(1):58-66.
[13] 杨洪强,朱杰,王中群,等. 血管生成素样蛋白2促进ApoE-/-小鼠动脉粥样硬化内膜钙化[J]. 中国动脉硬化杂志,2015,23(8):757-762.
[14] Horio E, Kadomatsu T, Miyata K, et al. Role of endothelial cell-derived Angptl 2 in vascular inflammation leading to endothelial dysfunction and atherosclerosis progression[J]. Arterioscler Thromb Vasc Biol,2014,34(4):790-800.
[15] 王树源,黄家卓,赵东华. Angptl 2联合hs-CRP检测在早期诊断急性冠脉综合征中的意义[J]. 中国医药科学,2017,7(2):166-168.