The Relationship Between Vascular Endothelial Function And Microalbuminuric In Patients With Coronary Heart Disease

Objective:The objective of the present study was to detect urinary albumin-to-creatinine ratio(UACR) and the concentrations of ET-1, AⅡ, VEGF and hs-CRP of serum in patients of coronary heart disease, analyse the relationship of them to coronary heart disease and severity of coronary artery disease, and discussing the relationship between of MAU to vascular endothelial function.Methods:A total of415patients hospitalized in Tianjin Chest Hospital from Sep.2010to Nov.2011with the result of CAG were divided into2groups:260patients in coronary heart disease(CHD) group and155in the normal group. Then the CHD group was divided into4groups with the categorical threshold of Gensini score by quartile values:A group (3～19scores) with65cases, B group (19～34scores) with67, C group (34～58scores) with65and D group (58～150scores) with63. The serum samples were got from the cubital vein next morning after hospitalized. The levels of ET-1and All were measured by radioimmunoassay, VEGF and hs-CRP by enzyme-linked immunosorbnent assay, urinary albumin by immunity transmission turbidity, and creatinine by oxidase method, then computed the ratio of urinary albumin to creatinine.Results:1. The levels of ET-1, AⅡ, VEGF, hs-CRP:The levels of four serological indexes above in CHD group were higher than that in normal group evidently (P<0.01), the levels of them increased gradually from A to D group. Among the four groups, the levels of four serological indexes were statistically significant(P<0.05), but the ET-1, AⅡ between B and C groups. The levels of ET-1, All, VEGF, and hs-CRP showed a positive correlation with Gensini score(the correlational coefficient respectively was0.434,0.444,0.773, and0.477, P<0.05).2. The level of UACR:The level of UACR in CHD group was higher than that in normal group evidently(P<0.01), the level of it increased gradually from A to D group (P<0.05), The level of UACR showed a positive correlation with Gensini score(the correlational coefficient was0.562,P<0.05).3. The relationship of UACR and four serological indexes:The level of UACR showed a positive correlation with ET-1、AⅡ VEGF and hs-CRP (the correlational coefficient respectively was0.226,0.190,0.497, and0.314, P<0.05).4. A multivariate logistic regression with binary category analysis indicated that both of UACR and hs-CRP were independent risk factor for coronary heart disease (P<0.05).Conclusions:1. The levels of ET-1, AⅡ, VEGF, hs-CRP, and UACR in CHD group are higher than them in normal group evidently, it indicates that ET-1, AⅡ, VEGF, hs-CRP, and UACR are closely related to coronary heart disease. Therefore, detecting the concentrations of them may contribute to predict atherosclerosis.2. The levels of ET-1, AⅡ, VEGF, hs-CRP, and UACR show a positive correlation with Gensini score, it reflects that ET-1, AⅡ, VEGF, hs-CRP, and UACR are related with the severity of coronary artery disease. Therefore, detecting the concentrations of them may contribute to predict the severity of atherosclerosis.3. The level of UACR shows a positive correlation with ET-1, AⅡ, VEGF, and hs-CRP. Four serological indexes are marks of endothelial function, so the level of UACR may reflect the damage of endothelia function in some extent.4. Among many risk factors of coronary heart disease, UACR is a independent risk factor for coronary heart disease and closely relates with the severity of coronary artery disease. By this inference, controlling the microalbuminuria effectively may delay the occurrence and progress of cardiovascular disease.