老年冠心病患者血清Angptl2、Angptl4水平与冠状动脉狭窄程度的关系
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摘要
目的探究老年冠心病患者血清血管生成素样蛋白2(Angptl2)、血管生成素样蛋白4(Angptl4)水平与冠状动脉狭窄程度的关系。方法选取2015年6月至2017年6月解放军第二一〇医院收治的老年冠心病患者89例及同院同期健康体检者57例为研究对象,分别设为观察组与对照组,对两组临床资料进行回顾性研究。检测受试者血清Angptl2、Angptl4水平,采用冠状动脉造影评估冠状动脉狭窄程度,并根据Gensini评分将观察组分为a(低危组)、b(中危组)、c(重危组)三组,应用Pearson相关性分析法分析Angptl2、Angptl4水平与冠状动脉狭窄程度之间的关系,并分析影响冠状动脉狭窄程度的危险因素。结果观察组患者总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、Angptl2分别为(4. 59±0. 67) mmol/L、(1. 74±0. 29) mmol/L、(3. 18±0. 52) mmol/L、(2. 84±0. 36) ng/ml显著高于对照组的(3. 61±0. 43) mmol/L、(3. 26±0. 38) mmol/L、(2. 57±0. 36) mmol/L、(0. 89±0. 27) ng/ml,高密度脂蛋白胆固醇(HDL-C)、Angptl4分别为(1. 08±0. 24) mmol/L、(20. 68±3. 29) ng/ml显著低于对照组的(1. 96±0. 35) mmol/L、(38. 47±4. 82) ng/ml(P <0. 05); c组血清Angptl2为(3. 36±0. 49) ng/ml显著高于a组(1. 41±0. 18) ng/ml、b组(2. 17±0. 35)ng/ml,而Angptl4(13. 87±3. 85) ng/ml显著低于a组(29. 14±5. 26) ng/ml、b组(22. 59±4. 34) ng/ml(P <0. 05); Angptl2水平与Gensini积分呈显著正相关,Angptl4水平与Gensini积分呈显著负相关(P <0. 05);年龄、吸烟、高血压、糖尿病、Angptl2水平、Angptl4水平是影响冠状动脉狭窄程度的危险因素(P <0. 05)。结论老年冠心病患者血清Angptl2、Angptl4水平发生异常变化,与冠状动脉狭窄程度具有显著联系,也是影响冠状动脉狭窄程度的主要危险因素,从而为临床预防及治疗冠心病提供了新理论基础。
Objective To investigate the relationships between serum angiopoietin-like protein 2( Angptl2) and angiopoietin-like protein 4( Angptl4) levels with severity of coronary artery stenosis in elderly patients with coronary heart disease( CHD). Methods From June2015 to June 2017,89 elderly patients with coronary heart disease admitted to PLA 210 th hospital and 57 healthy persons admitted to the same hospital during the same period were selected as the research objects,and they were divided into observation group and control group respectively,the clinical data of the two groups were retrospectively studied. Serum Angptl2 and Angptl4 levels were measured,coronary artery angiography was used to evaluate the severity of coronary artery stenosis and the observation group was divided into three groups: a( low-risk group),b( medium-risk group) and c( severe group) according to Gensini score. Pearson correlation analysis was used to analyze the relationship between Angptl2,Angptl4 levels and the severity of coronary artery stenosis,and to analyze the risk factors affecting the severity of coronary artery stenosis. Results Total cholesterol( TC),triglyceride( TG),low density lipoprotein cholesterol( LDL-C),Angptl2 in the observation group were( 4. 59 ±0. 67) mmol/L,( 1. 74 ± 0. 29) mmol/L,( 3. 18 ± 0. 52) mmol/L,( 2. 84 ± 0. 36) ng/ml respectively,which were significantly higher than those in the control group( 3. 61 ± 0. 43) mmol/L,( 3. 26 ± 0. 38) mmol/L,( 2. 57 ± 0. 36) mmol/L,( 0. 89 ± 0. 27) ng/ml,while high density lipoprotein cholesterol( HDL-C) and Angptl4 were( 1. 08 ± 0. 24) mmol/L,( 20. 68 ± 3. 29) ng/ml respectively,which were significantly lower than those in the control group( 1. 96 ± 0. 35) mmol/L,( 38. 47 ± 4. 82) ng/ml( P < 0. 05). The serum Angptl2 of group c( 3. 36 ± 0. 49) ng/ml was significantly higher than that of group a( 1. 41 ± 0. 18) ng/ml and group b( 2. 17 ± 0. 35) ng/ml,while Angptl4 was( 13. 87 ± 3. 85) ng/ml significantly lower than that of group a( 29. 14 ± 5. 26) ng/ml and group b( 22. 59 ± 4. 34) ng/ml( P < 0. 05). Angptl2 level was positively correlated with Gensini score,and Angptl4 level was negatively correlated with Gensini score( P < 0. 05); age,smoking,hypertension,diabetes mellitus,Angptl2 and Angptl4 were risk factors for coronary artery stenosis( P < 0. 05). Conclusion The abnormal changes of serum Angptl2 and Angptl4 levels in elderly patients with coronary heart disease are significantly related to severity of coronary artery stenosis,and are also the main risk factors affecting severity of coronary artery stenosis,thus providing a new theoretical basis for clinical prevention and treatment of coronary heart disease.
Objective To investigate the relationships between serum angiopoietin-like protein 2( Angptl2) and angiopoietin-like protein 4( Angptl4) levels with severity of coronary artery stenosis in elderly patients with coronary heart disease( CHD). Methods From June2015 to June 2017,89 elderly patients with coronary heart disease admitted to PLA 210 th hospital and 57 healthy persons admitted to the same hospital during the same period were selected as the research objects,and they were divided into observation group and control group respectively,the clinical data of the two groups were retrospectively studied. Serum Angptl2 and Angptl4 levels were measured,coronary artery angiography was used to evaluate the severity of coronary artery stenosis and the observation group was divided into three groups: a( low-risk group),b( medium-risk group) and c( severe group) according to Gensini score. Pearson correlation analysis was used to analyze the relationship between Angptl2,Angptl4 levels and the severity of coronary artery stenosis,and to analyze the risk factors affecting the severity of coronary artery stenosis. Results Total cholesterol( TC),triglyceride( TG),low density lipoprotein cholesterol( LDL-C),Angptl2 in the observation group were( 4. 59 ±0. 67) mmol/L,( 1. 74 ± 0. 29) mmol/L,( 3. 18 ± 0. 52) mmol/L,( 2. 84 ± 0. 36) ng/ml respectively,which were significantly higher than those in the control group( 3. 61 ± 0. 43) mmol/L,( 3. 26 ± 0. 38) mmol/L,( 2. 57 ± 0. 36) mmol/L,( 0. 89 ± 0. 27) ng/ml,while high density lipoprotein cholesterol( HDL-C) and Angptl4 were( 1. 08 ± 0. 24) mmol/L,( 20. 68 ± 3. 29) ng/ml respectively,which were significantly lower than those in the control group( 1. 96 ± 0. 35) mmol/L,( 38. 47 ± 4. 82) ng/ml( P < 0. 05). The serum Angptl2 of group c( 3. 36 ± 0. 49) ng/ml was significantly higher than that of group a( 1. 41 ± 0. 18) ng/ml and group b( 2. 17 ± 0. 35) ng/ml,while Angptl4 was( 13. 87 ± 3. 85) ng/ml significantly lower than that of group a( 29. 14 ± 5. 26) ng/ml and group b( 22. 59 ± 4. 34) ng/ml( P < 0. 05). Angptl2 level was positively correlated with Gensini score,and Angptl4 level was negatively correlated with Gensini score( P < 0. 05); age,smoking,hypertension,diabetes mellitus,Angptl2 and Angptl4 were risk factors for coronary artery stenosis( P < 0. 05). Conclusion The abnormal changes of serum Angptl2 and Angptl4 levels in elderly patients with coronary heart disease are significantly related to severity of coronary artery stenosis,and are also the main risk factors affecting severity of coronary artery stenosis,thus providing a new theoretical basis for clinical prevention and treatment of coronary heart disease.
引文
[1]郑力辉,郭菲,韩笑,等.冠心病患者外周血内皮微粒变化及其与炎症因子的相关性研究[J].国际检验医学杂志,2015,36(21):3112-3114.
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[6]龚武田,罗廷富,刘欢,等.脉搏波传导速度在冠心病诊断及冠状动脉狭窄程度评估中的临床应用[J].现代生物医学进展,2016,16(21):4113-4115.
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[8]张凤,苗伟,王淑亚,等.STEMI患者血管生成素样蛋白2的表达及替格瑞洛与氯吡格雷的影响[J].临床心血管病杂志,2016,32(8):786-789.
[9]Horiguchi H,Endo M,Kawane K,et al.ANGPTL2 expression in the intestinal stem cell niche controls epithelial regeneration and homeostasis[J].EMBO J,2017,36(4):409-424.
[10]李新,姚理娜,潘栋.冠心病患者血浆血管生成素样蛋白2水平、颈动脉内膜-中层厚度及其相关性研究[J].实用临床医药杂志,2017,21(5):170-171.
[11]郭玲玉.血管生成素样蛋白2在心血管疾病的研究进展[J].医学综述,2016,22(2):235-238.
[12]陈重九,范思邈,郑瑞茂.血管生成素样蛋白-4在动脉粥样硬化过程中的双重作用[J].生理科学进展,2016,47(5):380.
[13]Dewey FE,Gusarova V,O'Dushlaine C,et al.Inactivating Variants in ANGPTL4 and Risk of Coronary Artery Disease[J].N Engl J Med,2016,374(12):1123-1133.
[14]Dijk W,Beigneux AP,Larsson M,et al.Angiopoietin-like 4 promotes intracellular degradation of lipoprotein lipase in adipocytes[J].JLipid Res,2016,57(9):1670-1683.
[15]杨茜,陈红.ANGPTL4与糖脂代谢及动脉粥样硬化相关疾病的研究进展[J].医学综述,2018,24(9):1693-1697.
[16]孙瑶,吕红彬,周琦,等.血管生成素样蛋白4(ANGPTL4)在增生型糖尿病视网膜病变患者血清和玻璃体中的表达[J].眼科新进展,2017,37(1):49-51,68.
[17]朱小莉,周云,孙晓靖.冠心病危险因素分析及其与冠状动脉狭窄程度的关系[J].中国循证心血管医学杂志,2017,9(12):1513-1515.
[2]Winther S,Schmidt SE,Holm NR,et al.Diagnosing coronary artery disease by sound analysis from coronary stenosis induced turbulent blood flow:diagnostic performance in patients with stable angina pectoris[J].Int J Cardiovasc Imaging,2016,32(2):235-245.
[3]梁越,张慧文,任补元,等.血管生成素样蛋白2在动脉粥样硬化疾病中的作用[J].中华老年多器官疾病杂志,2017,16(10):770-773.
[4]颜红兵马长生.美国冠心病诊断与治疗指南[M].2版.北京:中国环境科学出版社,2006:657.
[5]郑刚.无创心脏影像学检查在冠心病诊断中的临床应用价值[J].中华老年心脑血管病杂志,2016,18(2):221-224.
[6]龚武田,罗廷富,刘欢,等.脉搏波传导速度在冠心病诊断及冠状动脉狭窄程度评估中的临床应用[J].现代生物医学进展,2016,16(21):4113-4115.
[7]卜四江.冠心病患者尿微量白蛋白水平及动脉硬化指数与冠脉狭窄程度的关系分析[J].临床和实验医学杂志,2015,14(17):1443-1445.
[8]张凤,苗伟,王淑亚,等.STEMI患者血管生成素样蛋白2的表达及替格瑞洛与氯吡格雷的影响[J].临床心血管病杂志,2016,32(8):786-789.
[9]Horiguchi H,Endo M,Kawane K,et al.ANGPTL2 expression in the intestinal stem cell niche controls epithelial regeneration and homeostasis[J].EMBO J,2017,36(4):409-424.
[10]李新,姚理娜,潘栋.冠心病患者血浆血管生成素样蛋白2水平、颈动脉内膜-中层厚度及其相关性研究[J].实用临床医药杂志,2017,21(5):170-171.
[11]郭玲玉.血管生成素样蛋白2在心血管疾病的研究进展[J].医学综述,2016,22(2):235-238.
[12]陈重九,范思邈,郑瑞茂.血管生成素样蛋白-4在动脉粥样硬化过程中的双重作用[J].生理科学进展,2016,47(5):380.
[13]Dewey FE,Gusarova V,O'Dushlaine C,et al.Inactivating Variants in ANGPTL4 and Risk of Coronary Artery Disease[J].N Engl J Med,2016,374(12):1123-1133.
[14]Dijk W,Beigneux AP,Larsson M,et al.Angiopoietin-like 4 promotes intracellular degradation of lipoprotein lipase in adipocytes[J].JLipid Res,2016,57(9):1670-1683.
[15]杨茜,陈红.ANGPTL4与糖脂代谢及动脉粥样硬化相关疾病的研究进展[J].医学综述,2018,24(9):1693-1697.
[16]孙瑶,吕红彬,周琦,等.血管生成素样蛋白4(ANGPTL4)在增生型糖尿病视网膜病变患者血清和玻璃体中的表达[J].眼科新进展,2017,37(1):49-51,68.
[17]朱小莉,周云,孙晓靖.冠心病危险因素分析及其与冠状动脉狭窄程度的关系[J].中国循证心血管医学杂志,2017,9(12):1513-1515.