【摘要】：目的通過(guò)檢測(cè)急性冠脈綜合癥患者、穩(wěn)定型心絞痛患者和非冠心病患者血清PCSK9、LPS的水平,觀察PCSK9、LPS水平在冠心病患者中的變化,探討其與冠心病的關(guān)系,并探討血清PCSK9水平與LPS水平及脂蛋白之間的關(guān)系的相關(guān)性,進(jìn)一步為臨床上冠心病的預(yù)防與治療提供理論依據(jù)。方法選擇2015年12月-2016年6月新疆石河子大學(xué)醫(yī)學(xué)院第一附屬醫(yī)院心血管內(nèi)科住院的經(jīng)冠狀動(dòng)脈造影確診為冠心病的患者126例,其中急性冠脈綜合征組(ACS)65例,穩(wěn)定型心絞痛組(SAP)61例,另選冠狀動(dòng)脈造影檢測(cè)排除冠心病的患者49例作為對(duì)照組。入院后第二天空腹抽取靜脈血,送至我院相關(guān)檢驗(yàn)科進(jìn)行各項(xiàng)指標(biāo)的測(cè)定,包括C-反應(yīng)蛋白(CRP)、總膽固醇(TC)、甘油三酯(TG)、高密度脂蛋白-膽固醇(HDL-C)、低密度脂蛋白-膽固醇(LDL-C)、血常規(guī)、肝腎功等,并收集包括患者性別、年齡、煙史、飲酒史、高血壓、高血糖史等基線資料。通過(guò)酶聯(lián)免疫吸附測(cè)定的方法檢測(cè)血漿PCSK9和LPS水平。采用SPSS20.0軟件分析系統(tǒng)進(jìn)行分析。符合正態(tài)分布的計(jì)量資料用(?X±S)表示,計(jì)數(shù)資料采用N%表示。計(jì)量資料的比較采用t檢驗(yàn)或方差分析,計(jì)數(shù)資料組間比較采用χ2檢驗(yàn)。對(duì)于不符合正態(tài)分布的資料進(jìn)行對(duì)數(shù)轉(zhuǎn)換后進(jìn)行比較。PCSK9和血脂間的相關(guān)性采用Pearson法進(jìn)行相關(guān)性分析,P0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果1.ACS組血清PCSK9水平明顯高于SAP組和對(duì)照組(1.89±0.22 vs 1.65±0.35,1.89±0.22 vs1.45±0.34,P0.01),SAP組血清PCSK9水平高于對(duì)照組(1.65±0.35 vs1.45±0.34,P0.01);ACS組血清LPS水平明顯高于SAP組和對(duì)照組(1.18±0.184 vs 1.07±0.26,1.18±0.184 vs 0.97±0.28,P0.01),SAP組血清LPS水平高于對(duì)照組(1.18±0.184 vs 0.97±0.28,P0.01);2.ACS組患者的血漿PCSK9水平與LPS、LDL-C、TC、Apo B、Hs-CRP均呈正相關(guān)(r=0.509、0.516、0.479、0.470、0.448均為P0.01),在SAP組中,血漿PCSK9水平與LPS、LDL-C、TC、Apo B、TG呈正相關(guān)(r=0.338、0.341、0.374、0.378、0.026均為P0.05),而正常組患者血清PCSK9水平與相關(guān)血脂指標(biāo)及常規(guī)炎癥指標(biāo)均無(wú)相關(guān)關(guān)系,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論在冠心病患者中,血清PCSK9、LPS水平顯著升高,并在急性冠脈綜合癥患者中高于穩(wěn)定型心絞痛患者。在冠心病患者中,血清PCSK9水平與血清LPS水平呈正相關(guān)性;血清PCSK9水平與體內(nèi)膽固醇代謝指標(biāo)(TC、LDL-C、Apo B)等亦呈正相關(guān)性。臨床檢測(cè)血清PCSK9水平可作為管理冠心病的一項(xiàng)重要指標(biāo),具有臨床意義。
[Abstract]:Objective to observe the changes of serum PCSK9 lipopolysaccharide (LPS) in patients with acute coronary syndrome, stable angina pectoris and non-coronary heart disease, and to explore its relationship with coronary heart disease. To explore the relationship between serum PCSK9 level, LPS level and lipoprotein, and to provide theoretical basis for the prevention and treatment of coronary heart disease. Methods from December 2015 to June 2016, 126 cases of coronary artery disease were diagnosed by coronary angiography in Department of Cardiovascular Medicine, the first affiliated Hospital of Medical College of Shihezi University, Xinjiang, including 65 patients with acute coronary syndrome (ACS). (SAP) was found in 61 patients with stable angina pectoris and 49 patients who were excluded from coronary artery disease by coronary angiography. On the second day after admission, venous blood was collected on an empty stomach and sent to the relevant laboratory department of our hospital for the determination of various indexes, including C-reactive protein (CRP), total cholesterol, (TC), triglyceride, (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), blood routine. To collect baseline data including sex, age, smoking history, drinking history, hypertension and hyperglycemia. The levels of PCSK9 and LPS in plasma were detected by enzyme linked immunosorbent assay (Elisa). SPSS20.0 software analysis system is used to analyze. The metrological data according to normal distribution are expressed by (X 鹵S), and the counting data are expressed by N%. T test or ANOVA were used to compare the measurement data and 蠂 2 test was used to compare the counting data groups. The correlation between PCSK9 and blood lipid was compared after logarithmic conversion of non-normal distribution data. The correlation analysis between PCSK9 and blood lipids by Pearson method was statistically significant. Results the serum PCSK9 level in 1.ACS group was significantly higher than that in SAP group and control group (1.89 鹵0.22 vs 1.65 鹵0.51.89 鹵0.22 vs1.45 鹵0.34 P0.01). The serum PCSK9 level in 1.ACS group was significantly higher than that in control group (1.65 鹵0.35 vs1.45 鹵0.34 P0.01). The serum LPS level in 1.ACS group was significantly higher than that in SAP group and control group (1.18 鹵0.184 vs 1.07 鹵0.26 鹵1.18 鹵0.184 vs 0.97 鹵0.28 P0.01). The serum LPS level in 1.ACS group was significantly higher than that in control group (1.18 鹵0.184 vs 1.18 鹵0.184). (2) the plasma PCSK9 level in patients with ACS was positively correlated with the levels of LPSLDL-Con, TCU, Apo Hs-CRP (r = 0.509, 0.516, 0.479, 0.4700.48, all P 0.01), and in the SAP group, there was a positive correlation between the levels of plasma PCSK9 and the levels of Hs-CRP in the patients with ACS, and in the SAP group, there was a positive correlation between the levels of plasma PCSK9 and the levels of Hs-CRP. There was a positive correlation between plasma PCSK9 level and LDL-C ~ (1 +) TG (P < 0.05), but there was no correlation between serum PCSK9 level and blood lipid index and routine inflammation index in normal group (P0.05). Conclusion the level of serum PCSK9 LPS in patients with coronary heart disease is significantly higher than that in patients with acute coronary syndrome and stable angina pectoris. In patients with coronary heart disease, the serum PCSK9 level was positively correlated with the serum LPS level, and the serum PCSK9 level was positively correlated with the cholesterol metabolism index (TCU LDL-CU Apo B) in patients with coronary heart disease (CHD). Clinical detection of serum PCSK9 level can be used as an important index in the management of coronary heart disease and has clinical significance.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R541.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 向凝;馬文;楊涓;;老年冠心病患者前蛋白轉(zhuǎn)化酶枯草溶菌素9代謝特點(diǎn)與冠狀動(dòng)脈粥樣硬化的相關(guān)性[J];中國(guó)老年學(xué)雜志;2016年14期

2 吳娜瓊;李莎;郭遠(yuǎn)林;徐瑞霞;張彥;朱成剛;孫靜;卿平;李建軍;;血漿PCSK9水平與冠狀動(dòng)脈狹窄程度的相關(guān)性研究[J];臨床心血管病雜志;2016年03期

3 王蘇平;楚葉萌;吳曉君;趙紅;;Toll樣受體4在幽門(mén)螺旋桿菌感染致動(dòng)脈粥樣硬化中的作用[J];中國(guó)動(dòng)脈硬化雜志;2015年08期

4 趙雪峰;范兆普;;蛋白轉(zhuǎn)化酶枯草溶菌素9對(duì)診斷冠狀動(dòng)脈狹窄的價(jià)值研究[J];人民軍醫(yī);2015年06期

5 韓瓊;李燕燕;杜菲;馮津萍;;脂多糖誘導(dǎo)高脂家兔動(dòng)脈血管重塑的研究[J];中國(guó)循環(huán)雜志;2014年06期

6 侍陽(yáng);宋慶偉;于生才;鄒海明;;肝癌模型大鼠肝硬化期IL-1β、IL-6、TNF-α的水平變化及作用機(jī)制[J];中國(guó)老年學(xué)雜志;2013年22期

7 葉強(qiáng);雷寒;鄭文武;鄭舒展;陳壓西;;脂多糖通過(guò)LDLr誘導(dǎo)巨噬細(xì)胞泡沫化:炎癥應(yīng)激下巨噬細(xì)胞泡沫化的另一條通路[J];中國(guó)藥理學(xué)通報(bào);2013年08期

8 張亞軍;王茹;P.R.Mabounda Kounga;王紅霞;李麗輝;陳佩杰;;不同濃度低氧暴露對(duì)慢性疲勞綜合征建模小鼠血清IL-6、TNF-α及IL-1β水平的影響[J];中國(guó)運(yùn)動(dòng)醫(yī)學(xué)雜志;2013年06期

9 郭雯;付真真;崔琴;王坤林;孫妍;常毅娜;周紅文;;前蛋白轉(zhuǎn)化酶枯草溶菌素9在絕經(jīng)前后女性中的差異[J];中華內(nèi)分泌代謝雜志;2013年01期

10 林勇平;孟艷輝;鄭衛(wèi)東;劉忠民;;PCSK9基因I474V多態(tài)性與冠心病相關(guān)性的研究[J];檢驗(yàn)醫(yī)學(xué);2012年05期

相關(guān)會(huì)議論文 前1條

1 張彥;朱成剛;徐瑞霞;李莎;郭遠(yuǎn)林;孫靜;李建軍;;穩(wěn)定性冠心病患者循環(huán)中PCSK9濃度與纖維蛋白原水平的相關(guān)性研究[A];第十二屆全國(guó)脂質(zhì)與脂蛋白學(xué)術(shù)會(huì)議論文匯編[C];2014年

相關(guān)博士學(xué)位論文 前1條

1 唐志晗;PCSK9在動(dòng)脈粥樣硬化形成中的作用及機(jī)制研究[D];南華大學(xué);2014年

，

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