金忠志刚 赵红丽 王小溪 马妍 张晓丹 李潞

[摘要] 目的 探討脂联素（Adiponectin，APN）及高敏C-反应蛋白（High sensitivity C-reactive protein，hs-CRP）与冠状动脉钙化（Coronary artery calcification，CAC）的相关性，明确APN及hs-CRP能否作为冠脉钙化的评估指标。方法 选取2018年7月至2020年2月沈阳医学院附属第二医院冠心病住院患者115例，经血管内超声（Intravascular ultrasound，IVUS）检查后，进一步分组为Ⅰ级钙化24例，Ⅱ级钙化23例，Ⅲ级钙化20例，Ⅳ级钙化18例，无钙化患者30例，测定APN及hs-CRP血清浓度，对各组患者一般临床资料、相关血生化、APN及hs-CRP值进行统计分析。 结果 冠脉钙化各组血清APN水平均较无钙化组明显降低（P<0.01），Ⅱ级钙化组APN水平较I级钙化组明显降低（P<0.01），Ⅲ级钙化组APN水平较Ⅰ、Ⅱ级钙化组明显降低（P<0.01），Ⅳ级钙化组APN水平较Ⅰ、Ⅱ级钙化组明显降低（P<0.01），Ⅲ、Ⅳ级钙化组APN水平无明显差异（P>0.05）。各组间hs-CRP无明显差异（P>0.05）。 结论 APN可作为有无冠脉钙化及钙化程度的临床评测指标，hs-CRP无法作为有无冠脉钙化的临床评测指标。

[关键词] 冠状动脉钙化;脂联素;高敏C-反应蛋白;血管内超声

[中图分类号] R541.4          [文献标识码] B          [文章编号] 1673-9701（2021）35-0048-03

Research on the correlation between adiponectin and high sensitivity C-reactive protein and coronary artery calcification

JINZHONG Zhigang   ZHAO Hongli   WANG Xiaoxi   MA Yan   ZHANG Xiaodan   LI Lu

Department of Cardiology， the Second Affiliated Hospital of Shenyang Medical College， Shenyang   110002， China

[Abstract] Objective To investigate the correlation between adiponectin（APN） and high sensitivity C-reactive protein（hs-CRP） and coronary artery calcification（CAC）， and to determine whether APN and hs-CRP can be used as evaluation indexes of CAC. Methods A total of 115 patients with coronary heart disease hospitalized in the Second Affiliated Hospital of Shenyang Medical College from July 2018 to February 2020 were selected. After intravascular ultrasound examination， they were divided into 24 patients with grade Ⅰ calcification， 23 patients with grade Ⅱ calcification， 20 patients with grade Ⅲ calcification， 18 patients with grade Ⅳ calcification and 30 patients without calcification. The concentrations of APN and hs-CRP were measured. The general clinical data， relevant blood biochemistry， APN and hs-CRP values of each group were statistically analyzed. Results The levels of APN in serum were significantly lower in all groups with CAC than that in the group without CAC（P<0.01）. The level of APN was significantly lower in the grade Ⅱ calcification group than that in the grade I calcification group（P<0.01）. The level of APN was significantly lower in the grade Ⅲ calcification group than that in the grade I and the grade Ⅱ calcification group（P<0.01）. The level of APN was significantly lower in the grade Ⅳ calcification group than that in the grade I and the grade Ⅱ calcification group （P<0.01）. There was no significant difference in the level of APN between the grade Ⅲ calcification group and the grade Ⅳ calcification group（P<0.01）. There was no significant difference in hs-CRP among all groups（P>0.05）. Conclusion APN can be used as a clinical evaluation index for the presence and degree of CAC， while hs CRP cannot be used as a clinical evaluation index for the presence and degree of CAC.

[Key words] Coronary artery calcification; Adiponectin; High sensitivity C-reactive protein; Intravascular ultrasound

冠狀动脉粥样硬化硬性心脏病（Coronary athero-sclerotic heart disease，CHD）是冠状动脉发生粥样硬化，使血管腔狭窄或闭塞，导致心肌缺血缺氧或坏死而引起的心脏病，介入治疗是CHD主要治疗方法。中重度钙化、钙化结节可导致血管壁硬化、顺应性降低，介入术中易出现球囊通过困难、扩张不良、球囊破裂，冠脉内膜夹层、冠脉穿孔、支架膨胀不良及贴壁不良，晚期支架再狭窄及支架内血栓，手术难度增加、手术费用高，预后不良。有研究表明，冠状动脉钙化作为心血管事件的独立预测因子，是在冠状动脉粥样硬化基础上由多种酶、蛋白质及炎症细胞因子等调控的有序的、主动的调节过程。……