血清sRANKL水平与冠心病危险分层相关性的研究

发布时间：2018-05-20 05:18

本文选题：冠心病 + s　；参考：《南华大学》2015年硕士论文

【摘要】：研究背景及目的探讨不同类型冠心病患者血清可溶性核因子K-B受体活化因子配体(Soluble nuclear factor K-B receptor activation factor ligands,s RANKL)水平变化,以及血清s RANKL水平与Hs-CRP、超敏肌钙蛋白T、γ-谷氨酰转肽酶水平、GRACE评分和冠状动脉Gensini积分的相关性。方法抽血以ELISA法测定27例稳定性冠心病组和43例急性冠脉综合征(ACS)组患者(其中不稳定型心绞痛(UA)患者24例,急性心肌梗死(AMI)患者19例)及20例非冠心病对照组患者血清s RANKL水平,同时观察s RANKL水平与Hs-CRP、超敏肌钙蛋白T、γ-谷氨酰转肽酶、GRACE评分和冠状动脉Gensini积分的相关性。结果3组患者平均年龄、男女比例、体重指数、收缩压、舒张压、血脂、肌酐等临床基本资料比较差异均无统计学意义(P0.05),提示3组患者具有可比性。急性冠脉综合征组患者的血清s RANKL水平比稳定性冠心病组和非冠心病对照组显著降低(P0.01),其中,非冠心病对照组、稳定性冠心病组和急性冠脉综合征组的血清s RANKL水平分别为0.153±0.014、0.152±0.0156、0.143±0.014 ng/ml。亚组分析显示急性心肌梗死亚组和不稳定心绞痛亚组患者血清s RANKL水平与稳定性冠心病组和非冠心病对照组相比,均有明显降低(P0.05)。稳定性冠心病组患者血清s RANKL水平与非冠心病对照组相比差异没有统计学意义(P0.05)。ACS组患者血清γ-谷氨酰转肽酶、c Tn T和hs-CRP水平均高于稳定性冠心病和非冠心病对照组(P0.05),相关性检验显示血清γ-谷氨酰转肽酶和c Tn T水平与患者GRACE评分成正相关(P0.05),同时与冠状动脉Gensini积分也成正相关(P0.05)。血清s RANKL和Hs-CRP水平与患者GRACE评分和冠状动脉Gensini积分都无明显相关(P0.05)。而血清s RANKL水平与γ-谷氨酰转肽酶、c Tn T、hs-CRP水平都未显示出明显相关性(P0.05)。结论1)与非冠心病对照组和稳定性冠心病组相比,急性冠脉综合征组患者的血清s RANKL水平降低;血清γ-谷氨酰转肽酶、c Tn T和hs-CRP水平明显高于稳定性冠心病和非冠心病对照组;2)s RANKL联合其他血清学指标或联合GRACE评分可能能更有效预测冠心病危险分层。
[Abstract]:Background and objective to investigate the changes of serum soluble nuclear factor K-B receptor activating factor ligand (Soluble nuclear factor K-B receptor activation factor ligand sRANKL) in patients with coronary heart disease (CHD). The correlation of serum s RANKL level with Hs-CRP, T, 纬 -glutamyl transpeptidase (GRACE) score and Gensini score of coronary artery was also studied. Methods 27 stable coronary heart disease patients and 43 acute coronary syndrome patients (including 24 patients with unstable angina pectoris) were measured by ELISA method. The serum s RANKL levels were observed in 19 patients with acute myocardial infarction (AMI) and 20 patients without coronary heart disease (control group). The correlation of s RANKL levels with Hs-CRP, T, GRACE score and Gensini score of coronary artery was also observed. Results there were no significant differences in average age, ratio of male and female, body mass index, systolic blood pressure, diastolic blood pressure, blood lipids and creatinine between the three groups. The serum s RANKL levels in the patients with acute coronary syndrome were significantly lower than those in the stable coronary heart disease group and the non-coronary heart disease group. The serum s RANKL levels in the non-coronary heart disease control group, the stable coronary heart disease group and the acute coronary syndrome group were 0.153 卤0.014 0.152 卤0.0156 卤0.143 卤0.014 ng / ml, respectively. Subgroup analysis showed that the serum s RANKL levels in patients with acute myocardial infarction (AMI) and unstable angina pectoris (UAP) were significantly lower than those in patients with stable coronary heart disease (CHD) and control group (non-CHD). There was no significant difference in serum s RANKL levels between stable coronary heart disease group and control group. The serum levels of 纬 -glutamyl transpeptidase c TnT and hs-CRP in stable coronary heart disease group were higher than those in stable coronary heart disease group and non-coronary heart disease group. The correlation test showed that the serum levels of 纬 -glutamyl transpeptidase and c Tn T were positively correlated with the GRACE score and the Gensini score of the coronary artery. There was no significant correlation between serum s RANKL and Hs-CRP levels and GRACE score and Gensini score of coronary artery (P 0.05). The levels of serum s RANKL and 纬 -glutamyl transpeptidase c Tn TnTnhs-CRP did not show any significant correlation (P 0.05). Conclusion 1) compared with the control group and the stable coronary heart disease group, the serum s RANKL level in the patients with acute coronary syndrome was lower than that in the control group. The levels of serum 纬 -glutamyl transpeptidase C T and hs-CRP were significantly higher than those in stable coronary heart disease (CHD) and non-coronary heart disease (CHD) control groups combined with other serological indexes or GRACE scores, which might be more effective in predicting risk stratification of coronary heart disease (CHD).
【学位授予单位】：南华大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R541.4

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