摘要
目的:观察补体C3与冠状动脉病变程度的关系,为冠状动脉粥样硬化性心脏病(简称冠心病)防治提供应用基础、实验依据。方法:选择2003-09/2004-12清华大学第一附属医院心脏中心的胸痛患者178例,男110例,女68例,平均年龄(65±10)岁。纳入标准:均通过冠状动脉造影确定血管狭窄程度,均对检测项目知情同意。排除标准:有严重感染、结缔组织疾病的患者。①通过冠状动脉造影确定冠状动脉病变严重程度,病变血管分为冠状动脉左主干、前降支、回旋支、右冠状动脉4支,同一血管多处病变以狭窄最严重处计算。冠状动脉病变严重程度的分级根据国外文献的标准,冠状动脉内径狭窄程度小于50%视为正常,评分为0分,1支冠状动脉狭窄程度大于或等于50%评为1分,依次如果有2支、3支或4支冠状动脉内径狭窄大于或等于50%则评为2分、3分或4分。②所有患者于住院后3d内清晨空腹采取静脉血,采用免疫沉淀法测定患者血清补体C3浓度,同时调查其他可能的危险因素,根据本院正常值水平补体C3>1.20g/L视为高补体C3。根据血清补体C3的水平分为高C3组和正常C3组,其中高C3组56例,正常C3组122例。③计量资料如果符合正态分布则以x±s表示,采用t检验,如果不符合正态分布则采用M、max、min表示,采用秩和检验。采用Pearson相关分析,将两支以上冠状动脉病变视为严重病变,赋值为1,将无明显冠状动脉病变赋值为0,采用logistic回归分析进行危险度分析,计算比值比和95%可信区间。结果:胸痛患者178例,均进入结果分析,无脱落者。①单因素分析显示高补体C3患者血清C反应蛋白值和冠状动脉病变严重程度均显著低于正常补体C3患者。②相关分析显示:补体C3与冠状动脉病变严重程度呈负相关,具有统计学意义;补体C3与血清总胆固醇、三酰甘油及低密度脂蛋白呈正相关。③Logistic回归分析显示补体C3对于严重冠状动脉病变比值比为0.197,无统计学意义(P>0.05),未能进入回归方程,吸烟、年龄和C反应蛋白对于严重冠状动脉病变的比值比分别为21.301、1.211和1.112,且P<0.05,有统计学意义。结论:补体C3与冠状动脉病变严重程度相关,但可能不是独立危险因素。
AIM： To explore the association between complement C3 and the severity of coronary artery disease and lay a foundation and evidence for the prevention and cure of coronary artery disease. METHODS： 178 patients （110 males, 68 females） with chest pain admitted in Department of Cardiology, the First Hospital of Tsinghua University from September 2003 to December 2004 were selected; the mean age was （65±10） years. Inclusive criteria： The severity of angiostenosis was evaluated by coronary arteriongrephy. Exclusive criteria： Patients with severe infection and connective tissue diseases. （1）The severity of coronary artery disease was measured by coronary arteriongrephy. The pathological vessels included left trunk; left anterior descending coronary, left circumflex coronary artery and right coronary artery, as to the same vessel with many process, the most serious stenosis part was selected. The scoring of coronary artery disease was evaluated by the foreign criterions published before. The stenosis of arteries 〈 50% was regarded as normal, and scored 0; one branch of coronary arteries with stenosis ≥ 50% was scored 1; accordingly, 2, 3 or 4 branches of coronary arteries with stenosis ≥ 50% would score 2, 3 or 4, respectively. （2）The intravenous blood samples of patients were gained within 3 days after admission. The serum concentration of complement C3 in each patient was measured by immuno-precipitation. Other potential risk factors were investigated. High C3 referred to the concentration of C3 above 1.2 g/L. The patients were divided into high C3 group （n =56） and normal C3 group （n =122） according to the serum concentration of C3. （3）Measurement data consistent with normal distribution were expressed as mean＋SD, and analyzed by t-test. Otherwise, the data was expressed as M, max and min and analyzed by rank-sum test. The correlation of two variances was analyzed by Pearson correlation analysis. Two or more branch diseased arteries were assigned as 1, and no manifested coronary artery disease as 0. The risk factors were evaluated by logistic regression analysis. The odd ratios and 95% confidence interval were calculated. RESULTS： All 178 patients were involved in the result analysis without loss. （1）The C reactive protein level and the severity of coronary artery disease of the high C3 group were significantly lower than the normal C3 group. （2）Correlative analysis showed that the level of complement C3 was negatively correlated with the severity of coronary artery disease （P 〈 0.05）; and positively correlated with level of serum total cholesterol, triglyceride and low-density lipoprotein （P 〈 0.05）. （3）Logistic regression analysis showed that the odds ratio （OR） of complement C3 for severe coronary artery disease was 0.197 （P 〉 0.05）, the ORs of smoking, age and C reactive protein for severe coronary artery disease were 21.301, 1.211 and 1.112, respectively （P〈 0.05）. CONCLUSION： Complement C3 is associated with the severity of coronary artery disease, but perhaps it is not an independent risk factor.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第12期2348-2350,共3页
Journal of Clinical Rehabilitative Tissue Engineering Research
