李明,赵鸿彦,张亚玲,赵小渝,程标

• 1:四川省医学科学院·四川省人民医院(东院)心内科
• 2:遵义医学院附属医院心内科
• 3:四川省医学科学院·四川省人民医院(东院)肾内科
• 4:四川省医学科学院·四川省人民医院老年心血管内科

摘要(Abstract)：

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-c Tn I)、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。

关键词(KeyWords)： 冠心病;冠状动脉狭窄;老年人;生长分化因子15;超敏C反应蛋白

Abstract:

Keywords:

基金项目(Foundation): 贵州省科学技术基金项目(黔科合J字LKZ[2012]26号);; 四川省医学科学院·四川省人民医院苗圃科研课题(2014034)

作者(Author): 李明,赵鸿彦,张亚玲,赵小渝,程标

参考文献(References)：

• [1]CHEN J,LUO F,FANG Z,et al.GDF-15 levels and atherosclerosis[J].Int J Cardiol,2018(257):36.DOI:10.1016/j.ijcard.2017.10.037.
• [2]TZIKAS S,PALAPIES L,BAKOGIANNIS C,et al.GDF-15predicts cardiovascular events in acute chest pain patients[J].PLo S One,2017,12(8):e0182314.DOI:10.1371/journal.pone.0182314.
• [3]GEORGE M,JENA A,SRIVATSAN V,et al.GDF-15 A Novel Biomarker in the Offing for Heart Failure[J].Curr Cardiol Rev,2016,12(1):37-46.
• [4]TAYEFI M,TAJFARD M,SAFFAR S,et al.Hs-CRP is strongly associated with coronary heart disease(CHD):A data mining approach using decision tree algorithm[J].Comput Methods Programs Biomed,2017,141:105-109.DOI:10.1016/j.cmpb.2017.02.001.
• [5]FARROKHIAN A,BAHMANI F,TAGHIZADEH M,et al.Selenium Supplementation Affects Insulin Resistance and Serum hs-CRP in Patients with Type 2 Diabetes and Coronary Heart Disease[J].Horm Metab Res,2016,48(4):263-268.DOI:10.1055/s-0035-1569276.
• [6]LIANG Y H,HOU Y P,NIU H Y,et al.Correlation of highsensitivity C-reactive protein and carotid plaques with coronary artery disease in elderly patients[J].Exp Ther Med,2015,10(1):275-278.DOI:10.3892/etm.2015.2486.
• [7]HE L Y,ZHAO J F,HAN J L,et al.Correlation between serum free fatty acids levels and Gensini score in elderly patients with coronary heart disease[J].J Geriatr Cardiol,2014,11(1):57-62.DOI:10.3969/j.issn.1671-5411.2014.01.003.
• [8]史磊.血清低密度脂蛋白胆固醇和非高密度脂蛋白胆固醇水平与冠状动脉病变严重程度的相关性研究[J].实用心脑肺血管病杂志,2017,25(2):17-21.DOI:10.3969/j.issn.1008-5971.2017.02.005.
• [9]刘欢,李艳.生长分化因子-15在常见心血管疾病中的研究进展[J].微循环学杂志,2017,27(4):68-71.DOI:10.3969/j.issn.1005-1740.2017.04.015.
• [10]LIU D D,MEI Y A.Effects of growth differentiation factor-15(GDF-15)on neurological systems,cardiovascular diseases,and cancer progression[J].Sheng Li Xue Bao,2017,69(1):109-121.
• [11]VILA G,RIEDL M,ANDERWALD C,et al.The relationship between insulin resistance and the cardiovascular biomarker growth differentiation factor-15 in obese patients[J].Clin Chem,2011,57(2):309-316.DOI:10.1373/clinchem.2010.153726.
• [12]罗东雷,郭靖涛,李拥军,等.生长分化因子-15血清水平与急性心肌梗死相关性研究[J].重庆医学,2016,45(18):2491-2493.DOI:10.3969/j.issn.1671-8348.2016.18.013.
• [13]DOMINGUEZ R A,ABREU G P,AVANZAS P,et al.Effect of Serum Growth Differentiation Factor-15 and the Syntax Score on2-Year Outcomes in Patients With Acute Coronary Syndrome[J].Am J Cardiol,2016,117(10):1569-1574.DOI:10.1016/j.amjcard.2016.02.031.
• [14]HABIB S S,AL MASRI A A.Relationship of high sensitivity C-reactive protein with presence and severity of coronary artery disease[J].Pak J Med Sci,2013,29(6):1425-1429.
• [15]SEYEDIAN S M,AHMADI F,DABAGH R,et al.Relationship between high-sensitivity C-reactive protein serum levels and the severity of coronary artery stenosis in patients with coronary artery disease[J].ARYA Atheroscler,2016,12(5):231-237.
• [16]胡永寸.冠心病患者血清生长分化因子-15和脑钠肽及超敏C反应蛋白水平的变化[J].中华老年医学杂志,2015,34(9):962-963.DOI:10.3760/cma.j.issn.0254-9026.2015.09.009.
• [17]崔艳,李艳,戴雯,等.冠心病患者血清超敏C反应蛋白及胱抑素C水平分析[J].微循环学杂志,2015,25(4):57-60.DOI:10.3969/j.issn.1005-1740.2015.04.014.
• [18]杨艳,张福军,沈松坤,等.采用ROC曲线评价NT-pro BNP、c Tn I、Hcy、DD、hs-CRP对冠心病的诊断价值[J].检验医学,2018,33(1):15-19.DOI:10.3969/j.issn.1673-8640.2018.01.003.

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