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冠心病是以冠状动脉硬化(atherosclerosis,AS)为基础,以脂质、炎性细胞和结缔组织在动脉壁的沉积为特征的一种慢性渐进性疾病。有些患者首次发病时即表现为急性心肌梗死(acute myocardial infraction,AMI)、卒中或心源性死亡。因此,早期发现AS斑块,尤其是不稳定性斑块,具有重要的临床诊断意义。而生物标志物可更早、更准确地检测到冠心病。为此,本研究进行了血管紧张素Ⅱ(angiotensinⅡ,ATⅡ)、神经肽Y(neuropeptide Y,NPY)、胰岛素样生长因子1(insulin-like growth factor 1,IGF-1)、高敏C反应蛋白(high sensitive C-reaction protein,hs-CRP)水平的测定,旨在评估它们在冠心病严重程度中的应用价值,现报道如下。
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157例冠心病患者与60名正常对照者血浆ATⅡ、NPY、IGF-1和hs-CRP水平比较见表 1。157例CHD患者血浆ATⅡ水平与60名正常对照者相比,差异有统计学意义(tSA ATⅡ=2.257,P<0.05;tUSA ATⅡ=3.018,P<0.01;tAMI ATⅡ=4.143,P<0.001);血浆NPY水平较正常对照者增高(tSA NPY=1.413,P>0.05;tUSA NPY=2.148,P<0.05;tAMI NPY=3.068,P<0.01),但SA患者与正常对照者之间的差异无统计学意义;血浆IGF-1水平与正常对照者相比,差异有统计学意义(tSA IGF-1=2.121,P<0.05;tUSA IGF-1=2.937,P<0.01;tAMI IGF-1=4.217,P<0.001);血浆hs-CRP水平与正常对照者相比,差异有统计学意义(tSA hs-CRP=2.095,P<0.05;tUSA hs-CRP=2.867,P<0.01;tAMI hs-CRP=4.349,P<0.001)。血浆ATⅡ、NPY、IGF-1和hs-CRP水平随着SA、USA和AMI患者的严重程度而逐渐升高。
组别 例数 ATⅡ(μg/L) NPY(pg/ml) IGF-1(ng/ml) hs-CRP(mg/L) 正常对照组 60 32.18±7.70 152.32±23.11 49.45±11.56 2.25±0.48 冠心病组 157 70.28±11.26** 254.77±47.74* 71.36±21.36** 5.85±1.94** SA 51 55.60±8.3* 160.13±26.58△ 58.21±15.89* 3.46±1.30* USA 45 70.35±12.01** 231.27±41.06* 74.82±20.86** 4.55±1.61** AMI 61 82.47±13.17*** 351.24±70.35** 86.05±28.13*** 8.81±2.72*** 注:表中,与正常对照组比较,△为P>0.05;*为P < 0.05;**为P < 0.01;***为P < 0.001;SA:稳定型心绞痛;USA:不稳定型心绞痛:AMI:急性心肌梗死;ATⅡ:血管紧张素Ⅱ;NPY:神经肽Y;IGF-1:胰岛素样生长因子1;hs-CRP:高敏C反应蛋白。 表 1 157例冠心病患者与60名正常对照者血浆ATⅡ、NPY、IGF-1和hs-CRP水平比较(x±s)
Table 1. The comparison of plasma ATⅡ, NPY, IGF-1 and hs-CRP levels between 157 patients with coronary heart diseases and 60 controls(x±s)
31例AMI患者随访恢复期的NPY水平为(163.47±28.55)pg/ml,与60例正常对照者差异无统计学意义(tNPY=1.837,P>0.05)。
血浆ATⅡ、NPY、IGF-1和hs-CRP水平测定在评估冠心病患者严重程度中的应用价值
The application value of plsama ATⅡ, NPY, IGF-1 and hs-CRP levels in evaluation of coronary heart disease severity
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摘要:
目的 探讨血浆血管紧张素Ⅱ(ATⅡ)、神经肽Y(NPY)、胰岛素样生长因子1(IGF-1)和高敏C反应蛋白(hs-CRP)水平测定在评估冠心病患者严重程度中的应用价值。 方法 采用放射免疫分析、酶免疫分析和高敏酶免疫分析法分别测定157例冠心病患者[包括51例稳定型心绞痛(SA)患者、45例不稳定型心绞痛(USA)患者和61例急性心肌梗死(AMI)患者]的血浆ATⅡ、NPY、IGF-1和hs-CRP水平,并与60名正常对照者进行对比分析。 结果 157例CHD患者血浆ATⅡ水平与60名正常对照者相比,差异有统计学意义(tSA ATⅡ=2.257,P<0.05;tUSA ATⅡ=3.018,P<0.01;tAMI ATⅡ=4.143,P<0.001);血浆NPY水平较正常对照者增高(tSA NPY=1.413,P>0.05;tUSA NPY=2.148,P<0.05;tAMI NPY=3.068,P<0.01),但SA患者与正常对照者之间的差异无统计学意义;血浆IGF-1水平与正常对照者相比,差异有统计学意义(tSA IGF-1=2.121,P<0.05;tUSA IGF-1=2.937,P<0.01;tAMI IGF-1=4.217,P<0.001);血浆hs-CRP水平与正常对照者相比,差异有统计学意义(tSA hs-CRP=2.095,P<0.05;tUSA hs-CRP=2.867,P<0.01;tAMI hs-CRP=4.349,P<0.001)。血浆ATⅡ、NPY、IGF-1和hs-CRP水平随着SA、USA和AMI患者的严重程度而增高。 结论 血浆ATⅡ、NPY、IGF-1和hs-CRP水平是判断冠心病患者严重程度的有价值指标,亦可以用于治疗后的随访。 Abstract:Objective To explore the application value of angiotensin Ⅱ(ATⅡ), neuropeptide Y(NPY), insulin-like growth factor 1(IGF-1) and high sensitive C-reaction protein(hs-CRP) levels in evaluation of the severity of coronary heart disease(CHD). Methods The plasma ATⅡ, NPY, IGF-1 and hs-CRP levels in 157 patients with CHD [including 51 cases with stable angina(SA), 45 cases with unstable angina(USA) and 61 cases with acute myocardial infraction(AMI)] were measured by radioimmunoassay, enzyme immunoassay and high sensitive enzyme immunoassay and were compared with 60 health controls. Results The plasma ATⅡ level in 157 patients with CHD was significantly higher than those in 60 controls(tSA ATⅡ=2.257, P < 0.05;tUSA ATⅡ=3.018, P < 0.01;tAMI ATⅡ=4.143, P < 0.001). The plasma NPY level in 157 patients with CHD was higher than those in 60 controls(tSA NPY=1.413, P > 0.05;tUSA NPY=2.148, P < 0.05;tAMI NPY=3.068, P < 0.01), but there were no significant difference between SA patients and the 60 conrols. The plasma IGF-1 level in 157 patients with CHD was significantly higher than those in 60 controls(tSA IGF-1=2.121, P < 0.05;tUSA IGF-1=2.937, P < 0.01;tAMI IGF-1=4.217, P < 0.001). The plasma hs-CRP level in 157 patients with CHD was significantly higher than those in 60 controls(tSA hs-CRP=2.095, P < 0.05;tUSA hs-CRP=2.867, P < 0.01;tAMI hs-CRP=4.349, P < 0.001). The four plasma biomarkers were increased with severity of CHD. Conclusion The plasma ATⅡ, NPY, IGF-1 and hs-CRP levels were valuable indexes for judging the severity of patients with CHD, and could be used for follow-up. -
表 1 157例冠心病患者与60名正常对照者血浆ATⅡ、NPY、IGF-1和hs-CRP水平比较(x±s)
Table 1. The comparison of plasma ATⅡ, NPY, IGF-1 and hs-CRP levels between 157 patients with coronary heart diseases and 60 controls(x±s)
组别 例数 ATⅡ(μg/L) NPY(pg/ml) IGF-1(ng/ml) hs-CRP(mg/L) 正常对照组 60 32.18±7.70 152.32±23.11 49.45±11.56 2.25±0.48 冠心病组 157 70.28±11.26** 254.77±47.74* 71.36±21.36** 5.85±1.94** SA 51 55.60±8.3* 160.13±26.58△ 58.21±15.89* 3.46±1.30* USA 45 70.35±12.01** 231.27±41.06* 74.82±20.86** 4.55±1.61** AMI 61 82.47±13.17*** 351.24±70.35** 86.05±28.13*** 8.81±2.72*** 注:表中,与正常对照组比较,△为P>0.05;*为P < 0.05;**为P < 0.01;***为P < 0.001;SA:稳定型心绞痛;USA:不稳定型心绞痛:AMI:急性心肌梗死;ATⅡ:血管紧张素Ⅱ;NPY:神经肽Y;IGF-1:胰岛素样生长因子1;hs-CRP:高敏C反应蛋白。 -
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