【摘要】 目的:检测不同侧支循环的冠心病患者补体C1q肿瘤坏死因子相关蛋白(CTRP1)的表达水平,探讨CTRP1表达水平与侧支循环程度、疾病严重程度及胰岛素抵抗的相关性。方法:选择82例在本院心内科进行选择性冠状动脉造影的患者,分析其侧支循环的形成情况。依据造影结果,以Rentrop评级标准评判患者的侧支循环,将患者分为:侧支循环不良组(CCB)47例;侧支循环良好组(CCW)35例。冠状动脉造影排除冠心病的患者为对照组(NC)37例;以Gensini计分方法评价冠状动脉病变的严重程度。分别检测各组患者血浆CTRP1表达水平,空腹血糖(FBG),空腹胰岛素(FINS),白细胞介素-6(IL-6),以及各组患者的临床资料,包括:TG,TC,HDL-C,LDL-C,计算胰岛素抵抗指数(HOMA-IR)等。检测Rentrop分级、Gensini评分和CTRP1表达水平与各指标的相关性,及以CTRP1为因变量分析其危险因素。结果:CCB组,CCW组与NC组比较,各检测指标均差异有统计学意义(P<0.05);Rentrop分级与血浆CTRP1表达水平,FBG,HOMA-IR,TG,IL-6及Gensini评分负相关,差异有统计学意义(P<0.05);Gensini评分与CTRP1,FBG,HOMA-IR,TG,IL-6呈正相关,差异有统计学意义(P<0.05);血浆CTRP1表达水平与TC,HOMA-IR,IL-6呈正相关,差异有统计学意义(P<0.05);采用多元逐步回归分析CTRP1表达水平的危险因素为HOMA-IR,IL-6,差异有统计学意义(P<0.05)。结论:冠心病患者血浆CTRP1表达水平与侧支循环程度以及胰岛素抵抗相关。更多还原

【Abstract】 Objective: To explore the relationship between collateral circulation,insulin resistance and the expression of CTRP1 in patients with coronary artery disease. Methods: 82 patients with coronary artery disease were divied into two groups named CCB group,CCW group depended on Rentrop,and 37 patients without coronary artery disease to be selected into NC group. The level of pathological changes was assessmented by Gensini. The indexs inclued CTRP1,FBG,FINS,TG,TC,HDL-c,LDL-c and IL-6,. And HOMA-IR was computated by the formula FBG × FINS/22. 5. The correlation among Rentrop,Gensini,expression of CTRP1 and clinic indexs was analyzed by Spearman and Pearson. The independent risk factors of expression of CTRP1 was analyzed by multiple regression. Results: There was significant difference of CTRP1,FBG,FINS,TG,TC,HDL-c,LDL-c,IL-6,and HOMA-IR in CCB group,CCW group and NC geoup( P < 0. 05). There was inverse correlation between Rentrop and the indexs of CTRP1,FBG,HOMA-IR,TG,IL-6,Gensini. There was correlation between Gensini and CTRP1,FBG,HOMA-IR,TG and IL-6. There was correlation between expression of CTRP1 and TC,HOMA-IR and IL-6. The independent risk factors of expression of CTRP1 were HOMA-IR and IL-6. Conclusion: There were significant relationship between exression of CTRP1 and collateral circulation or severity in patients with coronary artery disease. And HOMA-IR and IL-6 were the independent risk factors of expression of CTRP1.更多还原