马慧，张寿涛，毛艳华，安句英，张清潭

冠心病研究

老年急性冠状动脉综合征患者血浆网膜素-1、高敏C反应蛋白的表达及相关性

马慧，张寿涛，毛艳华，安句英，张清潭

目的：分析老年急性冠状动脉综合征（ACS）患者血浆网膜素-1与高敏C反应蛋白（hs-CRP）的相关性，探讨血浆网膜素-1对冠状动脉（冠脉）血管病变不稳定性的影响及作用机制。

方法：根据临床表现及冠脉造影结果入选ACS组74例、稳定性心绞痛（SAP）组66例，对照组60例为健康体检中心或同时期行冠脉造影结果正常者，酶联免疫吸附法测定血浆网膜素-1水平，比较三组血浆网膜素-1、hs-CRP水平和临床特点的差异，分析血浆网膜素-1与hs-CRP及其他临床指标的相关性。

结果：（1）与对照组和SAP组相比，ACS组血浆网膜素-1水平显著降低、hs-CRP水平显著升高（P均＜0.05）。（2）相关性研究显示，ACS组血浆网膜素-1水平与高密度脂蛋白胆固醇（HDL-C）呈显著正相关（r=0.262，P＜0.05）；与糖化血红蛋白（HbA1c）、心肌肌钙蛋白I（cTnI）、hs-CRP呈显著负相关（r=-0.25，P＜0.05；r=-0.285，P＜0.05；r=-0.278，P＜0.05）。（3）回归分析表明hs-CRP为影响血浆网膜素-1水平的独立相关因素（t=-3.137，P＜0.05），而血浆网膜素-1（HR=-3.653，95%CI： -1.157～-8.218，P＜0.001）和hs-CRP（HR=4.552，95%CI ：1.918～9.674，P＜0.001）均为ACS发生的独立影响因素，调整hs-CRP后，低血浆网膜素-1水平预测ACS的危险比从-3.653下降至-2.374。

结论：老年ACS患者血浆网膜素-1与hs-CRP浓度具有相关性，两者均为ACS发生的独立影响因素，血浆网膜素-1可能通过hs-CRP的介导影响ACS的发生，提示血浆网膜素-1可能作为保护性因子参与了ACS发生的炎症过程。

急性冠状动脉综合征；C反应蛋白质；网膜素-1

Objective: To analyze the expression and correlation of plasma levels of omentin-1 and high-sensitivity C-reactive protein (hs-CRP) in elder patients with acute coronary syndromes (ACS) and to explore the effect of omentin-1 on stability of coronary lesions with its possible mechanism.

Methods: Our research included in 3 groups: ACS group, n=74, Stable angina pectoris (SAP) group, n=66 and Normal control (NC) group, n=60. Plasma levels of omentin-1 were examined by ELISA, the correlations between omentin-1 and hs-CRP with other clinical indexes were compared among different groups.

Results:①Compared with NC and SAP groups, ACS group showed decreased plasma omentin-1 and increased hs-CRP, P＜0.05.②Correlation study presented that plasma levels of omentin-1 were positively related to HDL-C (r=0.262, P＜0.05), negatively related to HbA1c (r=-0.248, P＜0.05), cTnI (r=-0.285, P＜0.05) and hs-CRP (r=-0.278, P＜0.05).③ Multivariate regression analysis indicated that hs-CRP was the independent influencing factor for omentin-1 (t=-3.137, P＜0.05), while omentin-1 (HR=-3.653, 95% CI: -1.157 to -8.218, P＜0.001) and hs-CRP (HR=4.552, 95% CI: 1.918 to 9.674, P＜0.001) were the independent risk factors for ACS occurrence. With adjusted hs-CRP, low plasma level of omentin-1 on predicting the risk ofACS was attenuated from -3.653 to -2.374.

Conclusion: Plasma levels of omentin-1 and hs-CRP were correlated, either of them was an independent risk factor for ACS occurrence. Omentin-1 affecting ACS via hs-CRP mediation which suggesting that omentin-1 may play as a protector during infammatory process of ACS.

(Chinese Circulation Journal, 2016,30:1074.)

动脉粥样硬化不稳定斑块—易损斑块的破裂是急性冠状动脉综合征（ACS）发生中最重要的始动环节，斑块内在特性是斑块不稳定性的决定因素，包括内皮功能的严重不全、炎症反应的增强及胶原平滑肌细胞数量降低。……