检索历史 清除

目的:探讨脂肪因子Apelin、脂联素、Vaspin与老年人群冠状动脉粥样硬化性心脏病（CHD）易感性关系及对冠状动脉病变程度的影响。方法:回顾性选取2022年6月至2023年6月霍州煤电总医院收治的120例老年CHD患者（CHD组），并按1∶1比例选取同期120例无CHD的老年健康体检者作为对照组，比较两组基线资料、Apelin、脂联素、Vaspin水平，应用Logistic回归分析CHD易感性的相关因素，并比较不同CHD类型、狭窄程度、病变支数患者Apelin、脂联素、Vaspin水平，应用Spearman检验分析Apelin、脂联素、Vaspin与狭窄程度、病变支数的相关性。结果:CHD组Apelin、脂联素、Vaspin水平低于对照组[（70.02 ± 13.54） ng/L比（86.75 ± 7.40） ng/L、（2.03 ± 0.67） μg/L比（2.80 ± 0.29） μg/L、（1.02 ± 0.31） μg/L比（2.10 ± 0.28） μg/L]，差异有统计学意义（ P<0.05）。Logistic回归方程：Logit（ P） = 2.953 + 1.401 ×三酰甘油+ 1.446 ×低密度脂蛋白胆固醇- 0.761 × Apelin - 0.892 ×脂联素- 0.847 × Vaspin，每个系数差异均有统计学意义（ P<0.05），提示随着三酰甘油、低密度脂蛋白胆固醇水平升高及Apelin、脂联素、Vaspin水平降低，CHD易感性逐渐增加（ P<0.05）；稳定型心绞痛、不稳定型心绞痛、急性心肌梗死患者Apelin、脂联素、Vaspin水平依次降低（ P<0.05）；轻度、中度、重度狭窄CHD患者Apelin、脂联素、Vaspin水平依次降低（ P<0.05）；病变支数单支、双支、3支及以上患者Apelin、脂联素、Vaspin水平依次降低（ P<0.05）。Spearman检验结果表明，Apelin、脂联素、Vaspin与病变支数呈负相关（ r = - 0.686、- 0.773、- 0.717， P<0.05），与狭窄程度呈负相关（ r = - 0.728、- 0.808、- 0.779， P<0.05）。 结论:Apelin、脂联素、Vaspin与老年人群CHD易感性有关，且三者还与CHD狭窄程度、病变支数呈负相关，有望成为CHD诊断与判断病情程度的生物标志物。

Objective:To investigate the relationship between adipokines Apelin, adiponectin, Vaspin and susceptibility to coronary atherosclerotic heart disease (CHD) in the aged and their influence on the degree of coronary lesions.Methods:A total of 120 elderly patients with CHD admitted to Huozhou Coal and Power General Hospital from June 2022 to June 2023 were retrospectively selected(CHD group), and 120 elderly healthy physical examination subjects without CHD were selected as the control group in a 1:1 ratio. Baseline data, the levels of Apelin, adiponectin and Vaspin of the two groups were compared. Logistic regression was used to analyze the related factors of CHD susceptibility, and the levels of Apelin, adiponectin and Vaspin in patients with different CHD types, stenosis degree and number of lesions were compared. Spearman test was used to analyze the correlation between Apelin, adiponectin and Vaspin with stenosis degree and number of lesions.Results:The levels of Apelin, adiponectin and Vaspin in the CHD group were lower than those in the control group: (70.02 ± 13.54) ng/L vs. (86.75 ± 7.40) ng/L, (2.03 ± 0.67) μg/L vs. (2.80 ± 0.29) μg/L, (1.02 ± 0.31) μg/L vs. (2.10 ± 0.28) μg/L, there were statistical differences ( P<0.05). The Logistic regression equation was as follows: Logit ( P) = 2.953+1.401 × triglyceride + 1.446× low-density lipoprotein -0.761× Apelin -0.892 × adiponectin - 0.847 ×Vaspin, each coefficient had statistical significance ( P<0.05), it was suggested that with the increase of triglyceride and low-density lipoprotein levels and the decrease of Apelin, adiponectin and Vaspin levels, the susceptibility to CHD was gradually increased ( P<0.05). The levels of Apelin, adiponectin and Vaspin in patients with stable angina pectoris, unstable angina pectoris and acute myocardial infarction were decreased successively ( P<0.05). The levels of Apelin, adiponectin and Vaspin in patients with mild, moderate and severe stenosis were decreased successively ( P<0.05). The levels of Apelin, adiponectin and Vaspin in patients with single, double, 3 or more branches were decreased successively ( P<0.05). The results of Spearman test showed that Apelin, adiponectin and Vaspin were negatively correlated with the degree of stenosis ( r = - 0.728, - 0.808, - 0.779, P<0.05) and the number of lesions ( r = - 0.686, - 0.773, - 0.717, P<0.05). Conclusions:Apelin, adiponectin, and Vaspin are associated with the susceptibility of elderly people to CHD, and all three are negatively correlated with the severity of CHD stenosis and the number of diseased vessels. They are expected to become biomarkers for the onset and severity of CHD, providing a target idea for the prevention and treatment of CHD.