摘要
目的研究载脂蛋白CⅢ在急性心肌梗死患者和非冠心病患者血清中的水平是否具有显著性差异,并探讨其临床意义。方法选取心内科住院治疗的患者共110例,将其分为急性心肌梗死组（84例）与非冠心病组（26例）。收集患者住院期间的一般临床资料,包括年龄、性别、是否有高血压、糖尿病、血脂异常症、吸烟史;血生化指标等资料,包括血清肌钙蛋白Ⅰ、甘油三酯、总胆固醇、低密度脂蛋白胆固醇（LDLC）、高密度脂蛋白胆固醇（HDLC）、尿酸、同型半胱氨酸、血清脑钠肽、射血分数;血清炎症指标资料,包括血清胱抑素C及高敏C反应蛋白。测定每位患者血清载脂蛋白CⅢ的浓度,比较急性心肌梗死组与非冠心病组患者各项临床资料及载脂蛋白CⅢ的水平。结果心肌梗死组患者中男性较非冠心病组更多（P〈0.05）,吸烟率较非冠心病组更高（P〈0.05）;心肌梗死组患者血清肌钙蛋白Ⅰ、血清脑钠肽水平高于非冠心病组（P〈0.05）,而HDLC、射血分数低于非冠心病组（P〈0.05）;心肌梗死组血清胱抑素C、高敏C反应蛋白水平显著高于非冠心病组（P〈0.01）,同时测定结果显示心肌梗死组血清载脂蛋白CⅢ水平显著高于非冠心病组（P〈0.01）。多元线性回归分析显示,载脂蛋白CⅢ与性别、吸烟史、HDLC、肌钙蛋白Ⅰ、脑钠肽、射血分数、胱抑素C、高敏C反应蛋白之间无显著相关性。结论急性心肌梗死患者血清载脂蛋白CⅢ水平显著高于非冠心病患者,考虑载脂蛋白CⅢ通过影响血脂代谢来促进动脉粥样硬化形成,其过程中有多种炎症介质参与,推测载脂蛋白CⅢ可能成为急性心肌梗死炎症反应程度的预测指标。
Aim To observe the level of apolipoprotein CⅢ（ Apo CⅢ） in the serum between the patients with acute myocardial infarction and non-coronary heart disease whether they were significantly different,and to explore its clinical significance. Methods A total of 110 patients were enrolled. They were divided into acute myocardial infarction group and non-coronary heart disease group,including 84 people in acute myocardial infarction group,and 26 people in non-coronary heart disease group. The clinical data of patients during hospitalization were collected,including general information such as age,sex,hypertension,diabetes mellitus,dyslipidemia,smoking history,and blood biochemical index data,including serum troponin Ⅰ（ cTnⅠ）,triglyceride（ TG）,total cholesterol（ TC）,low density lipoprotein cholesterol（ LDLC）,high density lipoprotein cholesterol（ HDLC）,uric acid（ UA）,homocysteine,serum brain natriuretic peptide（ BNP）,ejection fraction（ EF）,and serum inflammation index data,including serum cystatin C（ Cys C） and high-sensitivity C-reactive protein（ hs-CRP）. The levels of serum apolipoprotein CⅢ in each patient were measured. Results Compared with non-coronary heart disease group（ P〈0.05）,there were more males in the myocardial infarction group,and smoking rate was higher than that of non-coronary heart disease group（ P〈0.05）. Serum cTnⅠ and serum BNP in patients with myocardial infarction were higher than those in non-coronary heart disease group（ P〈0.05）,while HDLC and EF were lower than those of non-coronary heart disease group（ P〈0.05）. The levels of serum Cys C,hs-CRP and apolipoprotein CⅢ in the myocardial infarction group were significantly higher than those in the non-coronary heart disease group（ P〈0.01）. Multivariate linear regression analysis showed that there was no significant correlation between apolipoprotein CIII and sex,smoking history,HDLC,cTnⅠ,BNP,EF,Cys C,hs-CRP which were significantly different between the two groups. Conclusion The levels of serum apolipoprotein CⅢ in patients with acute myocardial infarction were significantly higher than those in patients without coronary heart disease. Considering that apolipoprotein CⅢ promotes the formation of atherosclerosis by affecting blood lipid metabolism and the process involves a variety of inflammatory mediators,apolipoprotein CⅢ may be a predictor of inflammatory response to acute myocardial infarction.
作者
王一同
贾志梅
WANG Yi-Tong;JIA Zhi-Mei(The First Affliated Hospital of China Medical University, Shenyang, Liaoning 110000, China)
出处
《中国动脉硬化杂志》
CAS
2018年第5期512-516,共5页
Chinese Journal of Arteriosclerosis
关键词
急性心肌梗死
载脂蛋白CⅢ
炎症反应
Acute myocardial infarction
Apolipoprotein C Ⅲ
Inflammatory response
