摘要
目的分析冠状动脉粥样硬化性心脏病(coronary atherosclerotic heart disease,CHD)患者血清前蛋白转化酶枯草溶菌素9(preprotein converting subtilisin kexin type 9,PCSK9)、载脂蛋白M(apolipoprotein M,apoM)水平与冠状动脉病变程度的关系。方法选取2019年3月至2020年10月南京医科大学附属南京医院收治的疑似CHD患者243例,根据冠脉造影检查结果,将确诊为CHD的162例患者作为CHD组,非CHD的81例患者作为对照组,比较两组的一般临床资料及PCSK9、apoM水平。根据冠状动脉病变支数将CHD患者分为单支病变组(43例)、双支病变组(80例)和三支病变组(39例)。根据Gensin积分将CHD患者分为轻度狭窄组(≤24分,51例)、中度狭窄组(25~49分,70例)和重度狭窄组(≥50分,41例)。分析不同冠状动脉病变支数和不同冠状动脉病变狭窄程度的CHD患者血清PCSK9、apoM水平的差异,探讨PCSK9、apoM与冠状动脉病变程度的相关性。结果CHD组患者血清PCSK9水平、总胆固醇、Gensin积分、高血压比例明显高于对照组,而血清apoM、高密度脂蛋白水平明显低于对照组,差异均有显著性(P<0.05)。随着冠状动脉病变支数增加,血清PCSK9水平逐渐升高,而apoM水平逐渐降低,两两比较差异均有显著性(均P<0.05)。随着冠状动脉病变狭窄程度加重,血清PCSK9水平逐渐升高,而apoM水平逐渐降低,两两比较差异均有显著性(均P<0.05)。CHD患者血清PCSK9水平与Gensin积分(r=0.655,P<0.001)、冠状动脉病变支数(rs=0.685,P<0.001)呈正相关,而apoM水平与Gensin积分(r=-0.748,P<0.001)、冠状动脉病变支数(rs=-0.672,P<0.001)呈负相关。结论CHD患者血清PCSK9、apoM水平与冠状动脉病变程度均具有较好的相关性,可作为评估CHD患者病情严重程度的可靠指标。
Objective To analyze the relationship between the levels of serum preprotein converting subtilisin kexin type 9(PCSK9)and apolipoprotein M(apoM)and the degree of coronary artery disease in patients with coronary heart disease(CHD).Method A total of 243 patients with suspected CHD who were followed up in Nanjing Hospital Affiliated to Nanjing Medical University from March 2019 to October 2020 were selected.According to the results of coronary angiography,they were divided into CHD group(162 cases)and control group(81 cases).The differences of PCSK9,apoM and general clinical data between the two groups were compared.According to the number of coronary artery lesions,CHD group was divided into single vessel lesion group(43 cases),double vessel lesion group(80 cases)and three vessel lesion group(39 cases).According to Gensin score,CHD patients were divided into mild stenosis group(51 cases),moderate stenosis group(70 cases)and severe stenosis group(41 cases).The differences of serum PCSK9 and apoM levels in CHD patients with different number of coronary artery lesions and different degree of coronary artery stenosis was analyzed,the correlation between PCSK9,apoM and the degree of coronary artery lesions was explored.Result The serum PCSK9,total cholesterol(TC),Gensin score and the proportion of hypertension in the CHD group were significantly higher than those in the control group,while the serum apoM and high density lipoprotein(HDL)were significantly lower than those in the control group(all P<0.05).With the increase of the number of coronary artery lesions,the level of serum PCSK9 gradually increased,while the level of apoM gradually decreased(all P<0.05).With the aggravation of the degree of coronary artery stenosis,the serum PCSK9 level gradually increased,while the apoM level gradually decreased(all P<0.05).Serum PCSK9 level in CHD patients was significantly positively correlated with Gensin score(r=0.655,P<0.001)and number of coronary artery lesion(rs=0.685,P<0.001),while apoM level was significantly negative
作者
朱琪
贾海波
季梅丽
Zhu Qi;Jia Haibo;Ji Meili(Department of Geriatrics,Nanjing Hospital Affiliated to Nanjing Medical University,Jiangsu Nanjing 210008,China)
出处
《中国医刊》
CAS
2021年第10期1068-1071,共4页
Chinese Journal of Medicine
基金
江苏省卫生健康委科研课题(BJ19006)。
