【摘要】：目的觀察冠心病患者血清半乳糖凝集素-3(Galectin-3,Gal-3)及炎癥因子超敏C反應(yīng)蛋白(Hs-CRP)、白介素-6(IL-6)、腫瘤壞死因子-a(TNF-a)水平變化,探討冠心病患者血清Gal-3、Hs-CRP、IL-6、TNF-a與冠脈病變程度及30天內(nèi)主要心臟不良事件(MACE)的相關(guān)性。方法選取我院心內(nèi)科一病區(qū)住院患者180例作為研究對象,根據(jù)冠脈造影結(jié)果分為冠心病組(n=126例)和對照組(n=54例),檢測所有入選患者血清Gal-3、Hs-CRP、IL-6、TNF-a的水平。在冠心病組中根據(jù)不同血管病變支數(shù)分為單支病變組(n=54例)、雙支病變組(n=40例)和多支病變組(n=32例);再根據(jù)冠狀動脈狹窄的嚴(yán)重程度分為輕度狹窄組(n=51例)和重度狹窄組(n=75例);根據(jù)Gensini評分系統(tǒng)對所有研究對象進(jìn)行評分,并對冠心病患者出院后進(jìn)行為期30天的電話或門診隨訪,記錄每一位冠心病患者30天內(nèi)MACE的發(fā)生情況(主要包括心絞痛、心肌梗死、心力衰竭及心源性死亡等),并據(jù)此分為MACE組(n=23例)和無MACE組(n=104例)。分析各組間血清Gal-3、Hs-CRP、IL-6、TNF-a水平變化,同時從冠脈不同病變血管支數(shù)、冠脈狹窄程度和Gensini評分三方面來探討血清Gal-3、Hs-CRP、IL-6、TNF-a的水平與冠脈病變程度的關(guān)系,并分析其與及MACE之間的相關(guān)性。結(jié)果1.冠心病組血清Gal-3、Hs-CRP、IL-6、TNF-a水平及Gensini評分顯著高于對照組(P0.01)。2.冠狀動脈多支病變組血清Gal-3、Hs-CRP、IL-6、TNF-a水平顯著高于雙支、單支病變組及對照組(P0.05);雙支病變組又明顯高于單支病變組及對照組(P0.05)。3.冠狀動脈重度狹窄組血清Gal-3、Hs-CRP、IL-6、TNF-a水平顯著高于輕度狹窄組和對照組(P0.01);而輕度狹窄組又明顯高于對照組(P0.05)。4.冠心病組血清Gal-3、Hs-CRP、IL-6、TNF-a水平與Gensini積分呈正相關(guān)(回歸系數(shù)r=0.639、0.553、0.267、0.211,P0.01,P0.05)。5.對冠心病組進(jìn)行30天電話或門診隨訪,結(jié)果顯示MACE組中的Gal-3、Hs-CRP、IL-6、TNF-a水平顯著高于無MACE組(P0.01,P0.05)。結(jié)論1.冠心病患者血清Gal-3及Hs-CRP、IL-6、TNF-a水平明顯升高,并與冠狀動脈病變程度密切相關(guān),提示血清Gal-3可用來初步評估冠狀動脈病變的嚴(yán)重程度。2.冠心病患者血清Gal-3及Hs-CRP、IL-6、TNF-a水平與30天MACE密切相關(guān),提示Gal-3可作為冠心病患者近期預(yù)后的新觀察指標(biāo)。
[Abstract]:Objective to observe the changes of serum galactose agglutinin 3 (Galectin-3,Gal-3), inflammatory factor hypersensitive C-reactive protein (Hs-CRP), interleukin-6 (IL-6) and tumor necrosis factor-a (TNF-a) in patients with coronary heart disease (CHD). To investigate the correlation between serum Gal-3,Hs-CRP,IL-6,TNF-a and severity of coronary artery disease and (MACE) of main adverse cardiac events in 30 days in patients with coronary heart disease. Methods 180 inpatients in one ward of cardiology in our hospital were divided into coronary heart disease group (n = 126) and control group (n = 54) according to the results of coronary angiography. The serum Gal-3,Hs-CRP,IL-6,TNF-a levels of all patients were measured. In coronary heart disease group, 54 patients were divided into single vessel disease group (n = 54), double vessel lesion group (n = 40) and multivessel disease group (n = 32), and then divided into mild stenosis group (n = 51) and severe coronary artery stenosis group (n = 51) according to the severity of coronary artery stenosis. In the stenosis group (n = 75), all subjects were evaluated according to the Gensini scoring system. Patients with coronary heart disease were followed up by telephone or outpatient for 30 days after discharge. The incidence of MACE in each patient was recorded (including angina pectoris, myocardial infarction, angina pectoris, myocardial infarction). Heart failure and cardiac death were divided into MACE group (n = 23) and no MACE group (n = 104). The changes of serum Gal-3,Hs-CRP,IL-6,TNF-a levels were analyzed. The relationship between serum Gal-3,Hs-CRP,IL-6,TNF-a level and coronary lesion degree was discussed from three aspects: the number of coronary artery branches, the degree of coronary stenosis and the Gensini score, and the correlation between Gal-3,Hs-CRP,IL-6,TNF-a and MACE was also analyzed. Result 1. The serum Gal-3,Hs-CRP,IL-6,TNF-a level and Gensini score in CHD group were significantly higher than those in control group (P0.01). The level of serum Gal-3,Hs-CRP,IL-6,TNF-a in multi-vessel coronary artery lesion group was significantly higher than that in double vessel group, single vessel lesion group and control group (P0.05), and double vessel lesion group was significantly higher than single vessel lesion group and control group (P0.05). 3. The serum Gal-3,Hs-CRP,IL-6,TNF-a level in severe coronary stenosis group was significantly higher than that in mild stenosis group and control group (P0.01), while that in mild stenosis group was significantly higher than that in control group (P0.05). 4. There was a positive correlation between serum Gal-3,Hs-CRP,IL-6,TNF-a level and Gensini score in coronary heart disease group (regression coefficient r = 0.639U 0.553U 0.267U 0.211P 0.01P 0.05) .5. The results showed that the level of Gal-3,Hs-CRP,IL-6,TNF-a in MACE group was significantly higher than that in no MACE group (P 0.05). Conclusion 1. The levels of serum Gal-3 and Hs-CRP,IL-6,TNF-a were significantly increased in patients with coronary heart disease, and were closely related to the severity of coronary artery disease, suggesting that serum Gal-3 could be used to evaluate the severity of coronary artery disease. The levels of serum Gal-3 and Hs-CRP,IL-6,TNF-a in patients with coronary heart disease were closely correlated with MACE at 30 days, suggesting that Gal-3 could be used as a new index of short-term prognosis in patients with coronary heart disease.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R541.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前6條

1 陳偉偉;高潤霖;劉力生;朱曼璐;王文;王擁軍;吳兆蘇;李惠君;顧東風(fēng);楊躍進(jìn);鄭哲;蔣立新;胡盛壽;;《中國心血管病報告2015》概要[J];中國循環(huán)雜志;2016年06期

2 陳偉偉;高潤霖;劉力生;朱曼璐;王文;王擁軍;吳兆蘇;李惠君;鄭哲;蔣立新;胡盛壽;;《中國心血管病報告2014》概要[J];中國循環(huán)雜志;2015年07期

3 李徽;姚炯濤;張少利;;冠心病患者血清Gal-3檢測的臨床價值分析[J];河北醫(yī)藥;2015年10期

4 秦月;仲琳;楊軍;;冠心病患者冠狀動脈病變程度與半乳糖凝集素-3水平的相關(guān)性分析[J];中國循環(huán)雜志;2015年05期

5 張育民;李慶寬;全勇;史桂霞;肖曉霞;李峰;陳科新;梁薇芬;;急性心肌梗死患者血清半乳糖凝集素3水平與冠狀動脈病變的相關(guān)性[J];中國動脈硬化雜志;2014年06期

6 孫利強;陳杰;李恩;劉宗芳;張麗華;簡立國;;急性冠脈綜合征患者血清半乳糖凝集素-3和C反應(yīng)蛋白水平的變化[J];鄭州大學(xué)學(xué)報(醫(yī)學(xué)版);2014年03期

，

本文編號：2233882