血清生长分化因子15、超敏C反应蛋白水平与老年冠心病患者冠状动脉病变严重程度的相关性研究

摘要

目的 探讨血清生长分化因子15(GDF-15)、超敏C反应蛋白(hs-CRP)水平与老年冠心病患者冠状动脉病变严重程度的相关性.方法 选取2016年2—11月在四川省人民医院行冠状动脉造影的老年患者123例,根据冠状动脉造影结果分为冠心病组94例和非冠心病组29例;根据冠状动脉病变支数将冠心病组患者分为单支病变组28例、双支病变组35例、多支病变组31例,根据Gensini积分将冠心病组患者分为低分组24例(Gensini积分<32分)、中分组38例(Gensini积分32～82分)、高分组32例(Gensini积分>82分).比较冠心病组与非冠心病组患者实验室检查指标,并比较不同冠状动脉病变支数、不同Gensini积分冠心病患者血清GDF-15、hs-CRP水平,血清GDF-15、hs-CRP水平与冠心病患者Gensini积分的相关性分析采用Pearson相关分析.结果 冠心病组与非冠心病组患者血清总胆固醇(TC),三酰甘油(TG)、肌酐(Cr)、尿酸(UA)水平比较,差异无统计学意义(P>0.05);冠心病组患者血清HDL-C水平低于非冠心病组,血清低密度脂蛋白胆固醇(LDL-C)、超敏心肌肌钙蛋白I(hs-cTnI)、GDF-15、hs-CRP水平高于非冠心病组(P<0.05).多支病变组患者血清GDF-15、hs-CRP水平高于双支病变组、单支病变组,双支病变组患者血清GDF-15、hs-CRP水平高于单支病变组(P<0.05).高分组患者血清GDF-15、hs-CRP水平高于中分组、低分组,中分组患者血清GDF-15、hs-CRP水平高于低分组(P<0.05).Pearson相关分析结果显示,血清GDF-15(r=0.683)、hs-CRP(r=0.524)水平与老年冠心病患者Gensini积分呈正相关(P<0.01).结论 老年冠心病患者血清GDF-15、hs-CRP水平明显升高并与冠状动脉病变严重程度呈正相关,血清GDF-15、hs-CRP水平可在一定程度上反映老年冠心病患者冠状动脉病变严重程度.%Objective To investigate the correlations of serum levels of GDF-15 and hs-CRP with severity of coronary artery lesion in elderly patients with coronary heart disease(CHD). Methods A total of 123 elderly patients undergoingcoronary angiography were selected in Sichuan Provincial People's Hospital from February to November 2016,and they weredivided into CHD group(n=94)and non-CHD group(n=29)according to the coronary angiography results;patients in CHDgroup were divided into A1 group(with single-vessel lesion,n=28),A2 group(with double-vessel lesions,n=35)andA3 group(with multiple-vessel lesions,n=31)according to the number of stenosed coronary arteries,into B1 group(withGensini score less than 32,n=24),B2 group(with Gensini score equal or over 32 but less than 82,n=38)and B3 group(with Gensini score over 82,n=32)according to Gensini score. Laboratory examination results were compared between CHDgroup and non-CHD group,serum levels of GDF-15 and hs-CRP were compared in A1 group,A2 group and A3 group,in B1group,B2 group and B3 group,and Pearson correlation analysis was used to analyze the correlations of serum levels of GDF-15 and hs-CRP with Gensini score in elderly patients with CHD. Results No statistically significant differences of serum levelof TC,TG,Cr or UA was found between CHD group and non-CHD group(P>0.05);serum HDL-C level in CHD group wasstatistically significantly lower than that in non-CHD group,while serum levels of LDL-C,hs-cTnI,GDF-15 and hs-CRPin CHD group were statistically significantly higher than those in non-CHD group(P<0.05). Serum levels of GDF-15 and hs-CRP in A3 group were statistically significantly higher than those in A1 group and A2 group,meanwhile serum levels of GDF-15 and hs-CRP in A2 group were statistically significantly higher than those in A1 group(P<0.05). Serum levels of GDF-15and hs-CRP in B3 group were statistically significantly higher than those in B1 group and B2 group,meanwhile serum levels ofGDF-15 and hs-CRP in B2 group were statistically significantly higher than those in B1 group(P<0.05). Pearson correlationanalysis results showed that,serum levels of GDF-15(r=0.683)and hs-CRP(r=0.524)was positively correlated withGensini score in elderly patients with CHD(P<0.01). Conclusion Serum levels of GDF-15 and hs-CRP are significantlyelevated in elderly patients with CHD,and they are positively correlated with the severity of coronary artery lesion,may reflectthe severity of coronary artery lesion to some extent.