孙晓，张曼，王实，佟浩( 沈阳医学院附属中心医院，沈阳004;中国医科大学解剖教研室)

急性冠状动脉综合征患者血浆脑肠肽、肥胖抑制素水平变化及意义

孙晓1，张曼1，王实1，佟浩2
( 1沈阳医学院附属中心医院，沈阳110024;2中国医科大学解剖教研室)

摘要:目的观察急性冠状动脉综合征( ACS)患者血浆脑肠肽、肥胖抑制素水平变化，并探讨其临床意义。方法研究对象为108例ACS患者( A组)、30例健康体检者( B组)，采用放射免疫法检测两组血浆脑肠肽、肥胖抑制素的水平，并分析其与ACS危险因素的相关性。结果A组BMI、LDL、血压、颈动脉内中膜厚度( IMT)、颈动脉斑块所占比例明显高于B组( P均＜0.05)，血糖水平升高但差异无统计学意义。与B组比较，A组血浆脑肠肽水平降低、肥胖抑制素水平升高( P均＜0.05)，血浆脑肠肽/肥胖抑制素比值降低( P＜0.05)。相关性分析显示，A组血浆脑肠肽水平与BMI、IMT、LDL呈负相关( r分别为－0.17、－0.31、－0.22，P均＜0.05) ;血浆肥胖抑制素水平与IMT、LDL呈正相关( r分别为0.29、0.24，P均＜0.05)。结论ACS患者血浆脑肠肽水平降低、肥胖抑制素水平升高，二者可能参与了ACS的发生、发展。

关键词:急性冠脉综合征;动脉硬化;脑肠肽;肥胖抑制素

Changes in levels of ghrelin and obestatin in plasma of patients with acute coronary syndrome and the significance

SUN Xiao1，ZHANG Man，WANG Shi，TONG Hao
( 1 The Center Hospital Affiliated to Shenyang Medical College，Shenyang 110024，China)

Abstract:Objective To investigate the mechanism and significance of ghrelin and obestatin in the occurrence and development of acute coronary syndrome ( ACS).Methods A total of 108 ACS patients ( group A) and 30 healthy people( group B) were selected.The levels of ghrelin and obestatin in plasma were detected by radioimmunoassay，and the correlations of ghrelin and obestatin levels with the risk factors of ACS were analyzed.Results Compared with group B，the body mass index( BMI)，low density lipoprotein ( LDL)，blood pressure，intima-media thickness( IMT) and the proportion of carotid plaques were significantly higher in the group A ( P＜0.05)，the blood glucose levels increased，but it was not statistically significant.The ghrelin level was significantly lower and the obestatin level was significantly higher in the group A as compared with those of group B ( all P＜0.05).The G/O ratio of the group A was significantly lower than that of group B ( P＜0.05).Correlation analysis showed that the level of ghrelin in plasma was negatively correlated with BMI，LDL and IMT ( r =－0.17，－0.31 and－0.22; all P＜0.05) ; the level of obestatin in plasma was positively correlated with LDL and IMT( r =0.29，0.24; all P＜0.05).Conclusions The expression of plasma ghrelin and obestatin was abnormal in ACS patients，which may participate in the occurrence and development of atherosclerosis.

Key words:acute coronary syndrome; atherosclerosis; ghrelin; obestatin;correlation analysis

急性冠状动脉综合征( ACS)是以冠状动脉粥样硬化斑块破裂，继发完全或不完全闭塞性血栓形成为病理基础的一组临床综合征;是一种常见的严重的心血管疾病，是冠心病的一种严重类型。研究发现，糖脂代谢紊乱导致的血管损伤与动脉硬化的发生发展密切相关［1］，但具体机制目前尚不清楚。脑肠肽和肥胖抑制素是脑肠肽前体蛋白( proGRP)通过不同剪切和修饰产生的两种不同激素，两者在体内代谢中互为拮抗。……