中国医药
中國醫藥
중국의약
CHINA MEDICINE
2010年
1期
5-8
,共4页
任军梅%王瑞英%刘毅坚%李树峰%田树文
任軍梅%王瑞英%劉毅堅%李樹峰%田樹文
임군매%왕서영%류의견%리수봉%전수문
高血压病%冠状动脉病变%脂联素%基质金属蛋白酶9%血管紧张素Ⅱ%内皮素
高血壓病%冠狀動脈病變%脂聯素%基質金屬蛋白酶9%血管緊張素Ⅱ%內皮素
고혈압병%관상동맥병변%지련소%기질금속단백매9%혈관긴장소Ⅱ%내피소
Hypertension%Coronary artery remodeling%Adiponeetin%Matrix metalloproteinases-9:Angiotension Ⅱ: Endothelin
目的 探讨脂联素、基质金属蛋白酶9(MMP-9)、血管紧张素Ⅱ(AngⅡ)及内皮素(ET)-1与老年高血压病患者冠状动脉病变的关系.方法 选择拟诊为冠状动脉粥样硬化性心脏病(冠心病)行冠状动脉造影检查的老年患者173例.分对照组(30例),造影正常组(40例),冠状动脉粥样硬化组(40例),冠心病组(63例),采用酶联免疫吸附法测MMP-9浓度,采用放射免疫法测ET-1、Ang Ⅱ、脂联素水平.采用Gensini积分方法对冠状动脉病变程度进行定量评价.结果 高血压冠状动脉各亚组血浆中脂联素水平显著低于对照组(P<0.01),且脂联素随着重构增高逐渐降低(P<0.05);而MMP-9、AngⅡ、ET-1水平[造影正常组MMP-9、AngⅡ、ET-1分别为(274.4±70.1)μg/L,(59.2±15.4)μg/L,(5.0±1.0)μg/L,冠状动脉粥样硬化组分别为(478.5±79.3)μg/L、(69.3±18.2)μg/L、(7.3±2.4)μg/L,冠心病组分别为(615.8±112.8)μg/L、(95.9±26.1)μg/L、(9.0±1.0)μg/L]显著高于对照组[MMP-9、AngⅡ、ET-1分别为(137.2±35.6)μg/L、(45.8±13.2)μg/L、(3.3±1.0)μg/L](P<0.01),且随着重构增高逐渐增高(P<0.05).冠状动脉病变随着Gensini积分增高,血浆MMP-9、AngⅡ、ET-1水平逐渐增高(P<0.05),而脂联素水平逐渐下降(P<0.05).血浆脂联素水平与Gemini积分呈显著负相关(r=-0.714,P<0.01),血浆MMP-9、Ang Ⅱ、ET-1水平与Gemini积分呈正相关(r=0.841,P<0.01;r=0.760,P<0.01;r=0.880,P<0.01).多元线性回归分析显示,MMP-9、AngⅡ、ET-1是独立于收缩压、胆固醇外的与Gensini积分相关的因素.结论 高血压患者血浆MMP-9、AngⅡ、ET-1、脂联素浓度均可作为预测冠状动脉病变的发生、发展及病变严重程度的指标.
目的 探討脂聯素、基質金屬蛋白酶9(MMP-9)、血管緊張素Ⅱ(AngⅡ)及內皮素(ET)-1與老年高血壓病患者冠狀動脈病變的關繫.方法 選擇擬診為冠狀動脈粥樣硬化性心髒病(冠心病)行冠狀動脈造影檢查的老年患者173例.分對照組(30例),造影正常組(40例),冠狀動脈粥樣硬化組(40例),冠心病組(63例),採用酶聯免疫吸附法測MMP-9濃度,採用放射免疫法測ET-1、Ang Ⅱ、脂聯素水平.採用Gensini積分方法對冠狀動脈病變程度進行定量評價.結果 高血壓冠狀動脈各亞組血漿中脂聯素水平顯著低于對照組(P<0.01),且脂聯素隨著重構增高逐漸降低(P<0.05);而MMP-9、AngⅡ、ET-1水平[造影正常組MMP-9、AngⅡ、ET-1分彆為(274.4±70.1)μg/L,(59.2±15.4)μg/L,(5.0±1.0)μg/L,冠狀動脈粥樣硬化組分彆為(478.5±79.3)μg/L、(69.3±18.2)μg/L、(7.3±2.4)μg/L,冠心病組分彆為(615.8±112.8)μg/L、(95.9±26.1)μg/L、(9.0±1.0)μg/L]顯著高于對照組[MMP-9、AngⅡ、ET-1分彆為(137.2±35.6)μg/L、(45.8±13.2)μg/L、(3.3±1.0)μg/L](P<0.01),且隨著重構增高逐漸增高(P<0.05).冠狀動脈病變隨著Gensini積分增高,血漿MMP-9、AngⅡ、ET-1水平逐漸增高(P<0.05),而脂聯素水平逐漸下降(P<0.05).血漿脂聯素水平與Gemini積分呈顯著負相關(r=-0.714,P<0.01),血漿MMP-9、Ang Ⅱ、ET-1水平與Gemini積分呈正相關(r=0.841,P<0.01;r=0.760,P<0.01;r=0.880,P<0.01).多元線性迴歸分析顯示,MMP-9、AngⅡ、ET-1是獨立于收縮壓、膽固醇外的與Gensini積分相關的因素.結論 高血壓患者血漿MMP-9、AngⅡ、ET-1、脂聯素濃度均可作為預測冠狀動脈病變的髮生、髮展及病變嚴重程度的指標.
목적 탐토지련소、기질금속단백매9(MMP-9)、혈관긴장소Ⅱ(AngⅡ)급내피소(ET)-1여노년고혈압병환자관상동맥병변적관계.방법 선택의진위관상동맥죽양경화성심장병(관심병)행관상동맥조영검사적노년환자173례.분대조조(30례),조영정상조(40례),관상동맥죽양경화조(40례),관심병조(63례),채용매련면역흡부법측MMP-9농도,채용방사면역법측ET-1、Ang Ⅱ、지련소수평.채용Gensini적분방법대관상동맥병변정도진행정량평개.결과 고혈압관상동맥각아조혈장중지련소수평현저저우대조조(P<0.01),차지련소수착중구증고축점강저(P<0.05);이MMP-9、AngⅡ、ET-1수평[조영정상조MMP-9、AngⅡ、ET-1분별위(274.4±70.1)μg/L,(59.2±15.4)μg/L,(5.0±1.0)μg/L,관상동맥죽양경화조분별위(478.5±79.3)μg/L、(69.3±18.2)μg/L、(7.3±2.4)μg/L,관심병조분별위(615.8±112.8)μg/L、(95.9±26.1)μg/L、(9.0±1.0)μg/L]현저고우대조조[MMP-9、AngⅡ、ET-1분별위(137.2±35.6)μg/L、(45.8±13.2)μg/L、(3.3±1.0)μg/L](P<0.01),차수착중구증고축점증고(P<0.05).관상동맥병변수착Gensini적분증고,혈장MMP-9、AngⅡ、ET-1수평축점증고(P<0.05),이지련소수평축점하강(P<0.05).혈장지련소수평여Gemini적분정현저부상관(r=-0.714,P<0.01),혈장MMP-9、Ang Ⅱ、ET-1수평여Gemini적분정정상관(r=0.841,P<0.01;r=0.760,P<0.01;r=0.880,P<0.01).다원선성회귀분석현시,MMP-9、AngⅡ、ET-1시독립우수축압、담고순외적여Gensini적분상관적인소.결론 고혈압환자혈장MMP-9、AngⅡ、ET-1、지련소농도균가작위예측관상동맥병변적발생、발전급병변엄중정도적지표.
Objective To investigate the correlation among plasma APN,MMP-9,Ang Ⅱ,ET-1 levels and severity of coronary artery stenosis.Methods The plasma APN,MMP-9,AngⅡ,ET-1 levels were measured.The degree of artery stenosis was confirmed by coronalyangiographies and assessed quantitatively with Gensini score.Results In old patients with hypertension,the plasma APN level was significantly lower than that of control group (P<0.01).The plasma MMP-9,AngⅡ,ET-1 levels were significantly higher than that of control group(P<0.01).Gensini score increased as the APN level decreased(P<0.05)and the MMP-9,AngⅡ,ET-1 levels increased(P<0.05).The plasma levels of MMP-9,AngⅡ,ET-1 was found to be positively correlated with Gensini 8core(r=0.841,P<0.01;r=0.760,P<0.01;r=0.880,P<0.01).The plasma levels of adiponectin was found to be negatively correlated with Gensini score(,=-0.714,P<0.01).Multiple regression analysis showed that MMP-9,AngⅡ,ET-1 levels were independent factors of Gemini score.Conclusions The plasma MMP-9,AngⅡ,ET-1 levels and the plasma adiponeetin level are closely related to the degree of coronary artery and remode1ing in hypertension patients.The research showes that the plasma APN,MMP-9,Ang Ⅱ,ET-1 levels might be involved in the pathophysiologie process of coronary remodeling.
