天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (3): 274-277.doi: 10.11958/20161329

• 临床研究 • 上一篇    下一篇

急性冠脉综合征患者 PCSK9 水平及其与脂多糖的相关性分析

张修泽 1， 王丽 2△   

  1. 1 新疆石河子市， 石河子大学医学院 （邮编 832002）； 2 石河子大学医学院第一附属医院心内二科
  • 收稿日期:2016-11-10 修回日期:2016-12-07 出版日期:2017-03-15 发布日期:2017-03-21
  • 通讯作者: 王丽 E-mail:xiuzhe196@163.com

Changes of PCSK9 level in patients with acute coronary syndrome and correlation analysis with LPS

ZHANG Xiu-ze1, WANG Li2△   

  1. 1 Medical College of Shihezi University, Shihezi, Xinjiang 832002, China; 2 The Second Department of Cardiovascular Internal Medicine, First Affiliated Hospital, College of Medicine, Shihezi University
  • Received:2016-11-10 Revised:2016-12-07 Published:2017-03-15 Online:2017-03-21
  • Contact: WANG Li E-mail:xiuzhe196@163.com

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摘要： 摘要： 目的 探讨前蛋白转化酶枯草溶菌素 9（PCSK9）在急性冠脉综合征（ACS）患者中的水平及其与脂多糖 （LPS） 及脂蛋白的相关性。方法 选取 2015 年 12 月—2016 年 6 月在我院心血管内科住院的经冠状动脉造影确诊为冠心病的患者 126 例， 其中 ACS 组 65 例， 稳定型心绞痛 （SAP） 组 61 例， 另入组冠状动脉造影检测、 排除冠心病的患者 49 例作为对照组。于造影前空腹采血测定高敏 C 反应蛋白 （hs-CRP）、 三酰甘油 （TG）、 总胆固醇 （TC）、 高密度脂蛋白胆固醇（HDL-C）、 低密度脂蛋白胆固醇（LDL-C）、 载脂蛋白（apo） -A1、 apo-B、 空腹血糖（FPG）和血肌酐（Scr）水平； 通过酶联免疫吸附测定的方法检测血浆 PCSK9 和 LPS 水平。结果 ACS 组 PCSK9、 LPS、 hs-CRP、 LDL-C、TC、 apo-B 和空腹血糖水平明显高于 SAP 组和对照组 （P＜0.05）， HDL-C 低于对照组 （P＜0.05）； SAP 组 PCSK9、 LPS、LDL-C、 apo-B 水平高于对照组； ACS 患者的血浆 PCSK9 水平与 LPS、 hs-CRP、 LDL-C、 TC、 apo-B 均呈正相关 （r 分别为 0.509、 0.373、 0.516、 0.479、 0.470， 均为 P＜0.05）。结论 血清 PCSK9 和 LPS 参与冠状动脉粥样硬化的发生发展过程， PCSK9 可能通过参与血管壁炎症反应及脂质代谢促进 ACS 的发生。

关键词: 冠心病, 急性冠脉综合征, 前蛋白转化酶枯草溶菌素9, 脂多糖, 低密度脂蛋白胆固醇

Abstract: Abstract: Objective To explore the correlation between PCSK9 and LPS or lipoprotein in patients with acute coronary syndrome (ACS). Methods A total of 126 patients with coronary artery disease confirmed by coronary angiography were selected in our hospital from December 2015 to June 2016, including 65 patients with ACS and 61 patients with stable angina (SAP). And 49 patients without coronary heart disease confirmed by coronary angiography were used as the control group. Values of high sensitivity C reactive protein (hs- CRP), triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein (apo)-A1 , apo-B and fasting plasma glucose (FPG) were measured by fasting blood before radiography. Plasma PCSK9 and LPS levels were measured by enzyme-linked immunosorbent assay. Results The levels of PCSK9, LPS, hs-CRP, LDL-C, TC, apo-B and fasting blood glucose were significantly higher in ACS group than those in SAP group and control group (P < 0.05), and HDL-C was lower than that of the control group (P < 0.05). PCSK9, LPS, LDL-C and apo-B levels were higher in SAP group than those of control group. The levels of plasma PCSK9 were positively correlated with LPS, hs-CRP， LDL-C, TC and apo-B in ACS patients (r = 0.509, 0.373, 0.516, 0.479, 0.470, all P < 0.05). Conclusion Plasma PCSK9 and LPS are involved in the development of coronary atherosclerosis. PCSK9 may play an important role in the pathogenesis of ACS by participating in the inflammatory reaction and lipid metabolism.

Key words: coronary heart disease, acute coronary syndrome, proprotein convertase subtilisin/kexin type 9, lipopolysaccharide, low-density lipoproteincholesterol