| Objective: Coronary heart disease is coronary artery heart disease, CHD,refers to the coronary stenosis or insufficiency caused by insufficient bloodsupply and caused myocardial ischemia and hypoxia, dysfunction and theseverity of coronary artery atherosclerosis or spasm (or) implement qualitativesex pathological change is the most common thing. Coronary heart disease isone of the diseases with the highest mortality world-wide, The United StatesNational Center for health statistics show that in1988the United Statesannounced in1987the death toll and the death causes data, heart diseaseaccounted for35%of total death, including coronary heart disease deathsaccounted for24.1%, ranking to the first of the top10causes ofdeath.According to the2011report of WHO, coronary heart disease death tollof China has listed the second of the world[14]. In recent years, the incidence ofcoronary heart disease is on the rise and becomes younger and younger, and itseriously does harms to the human health.For a long time, there have beenmore information to prove that high-risk coronary heart disease andhypertension, hyperlipidemia, type-2diabetes, insulin resistance, lowendocrine function and other factors are closely related.There is somecorrelation between bad life style and drinking, smoking, genetic,environmental factors and predisposing factors.In the past, we think that the main function of adipose tissue is to storeand supply energy.In1994, Friedman found a fat secretion of the hormone,leptin, understanding of adipose tissue which has undergone fundamentalchanges in the regulatory process, the balance of energy metabolism inadipose tissue plays an important role in. With the deeper research, weconfirmed that adipose tissue has a wide spectrum of secretion, can secrete alarge number of adipocytokines such as leptin (leptin), adiponectin, resistin (adiponectin)(resistin), P-selectin (omen tin), visfatin (V is fa Ti n),chemokine (CH EM e RI n) and VA sP in, retinol binding protein4(retinolbinding Pro tein-4, RBP-4), and a large number of biologically activesubstances such as fatty acid, steroid hormone, growth factor, angiotensin andprostaglandins etc.. are found.Some fat cells factor only derived from adiposecells, some can also be produced by other tissues of the body.The leptin(leptin), adiponectin (adiponectin)(resistin), resistin, visfatin (visfatin) andP-selectin (omentin) is produced by fat cells and generated; interleukin6(interleukin-6, IL-6) and tumor necrosis factor α (tumor necrosis factor-α,TNF-α) and chemokines are inflammatory factor (Neels.2006) are not onlygenerated by other cells, adipose tissue can also generate; plasminogenactivator inhibitor (plasminogen activator inhibitor1, PAI-1) and vascularendothelial growth factor (vascular endothelial growth factor, VEGF) and(Chudek.2006) is mainly composed of mononuclear macrophage generation.There are mutual influence between various factors, its expression andsecretion are regulated by various factors,and plays a great role inmaintaining the normal physiological function of the body and a variety ofdiseases.Various studies have indicated that these adipokines also play animportant role in insulin resistance and sensitivity, substance metabolism,genetic variation, inflammation and vascular biology in obesity,atherosclerosis, inflammation, in response, lipid metabolism disorders,cardiovascular disease, type-2diabetes, hypertension, insulin resistancesyndrome.The study of adiponectin, leptin and resistin is larger, the otherfactor such as the study of chemotactic factor, omentin are less. To furtherclarify the role of adipokines bound for many cardiovascular diseasesespecially provide new targets for prevention and treatment of coronary heartdisease.This study was designed to observe the acute coronary syndrome patientsSerum P-selectin (omen tin), chemokine (CH EM e RI n) changes in patientswith acute coronary syndrome, further study of Serum P-selectin (omen tin),chemokine (CH EM e RI n) relationship with the degree of coronary artery disease.It can provide new ideas for prevention and treatment ofcardiovascular disease.Methods:1We take from December,2012to October,2011in the SecondAffiliated Hospital of Hebei Medical University, the50cases of patients ofDepartment of Cardiology of acute coronary syndrome (unstable angina, acutemyocardial infarction),they were recorded as unstable angina, acutemyocardial infarction group.The normal group of50cases are healthy peoplenot having the coronary artery disease by coronary diagnosis ofangiography.We respectively record the patients’ age, gender, height, weight,body mass index, fasting venous blood of high sensitivity C-reactive protein.2Extract the patients’ vein blood before8hours of fasting venous blood,using ELISA method for the determination of Serum P-selectin (omen tin),chemokine (CH EM e RI n) level.3Calculation methods of Gensini integralCoronary artery angiography records number of diseased vessels, Gensiniscore was calculated according to the results, and make quantitativeassessment of the vessels of coronary artery lesions in each.Three groups wereobserved the differences in patients with Serum P-selectin (omen tin),chemokine (CH EM e RI n) level and body mass index.Serum P-selectin(omen tin), chemokine (CH EM e RI n) correlation between concentration andnumber of coronary lesions.Serum P-selectin (omen tin), chemokine (CH EMe RI n) correlation between concentration level and coronary angiographyGensini integral.Statistical analysis of data using SPSS13.0statistical software,continuous variables are expressed in x±s.Normal distribution are tested withKolmolgoro2smirnovtest. The differences between groups were analyzed bySNK multivariate analysis of variance comparison. Correlation analysis ofbivariate correlation analysis use the method of Spearman. Correlationanalysis uses multiple linear regression analysis. Two-tailed P≤0.05wasconsidered statistically significant. Results:1Four groups of subjects were not statistically significant (BMI, P>0.05)2The serum levels of chemokine levels were significantly higher thanthose in normal control group。And unstable angina pectoris group serumchemokine was higher than the levels in acute myocardial infarction group.Acute myocardial infarction group serum chemokines levels are set for highcontrast. In addition to acute ST segment elevation myocardial infarctiongroup and acute non ST segment elevation myocardial infarction group, serumtotal testosterone levels tend to mean no significant difference (P>0.05), othergroups of serum chemokine levels were statistically significant.3Omental serum-1levels were significantly lower than those in thenormal control group. The overall mean of the unstable angina group and theacute ST segment elevation myocardial infarction group has no significantdifference (P <0.05). Unstable angina group, serum retinal elevationmyocardial infarction group with acute ST segment-1level was acute non STsegment elevation myocardial infarction group was low, the overall meandifferences were statistically significant (P <0.05). Acute non ST segmentelevation myocardial infarction group than in the control group was low, theoverall mean differences were statistically significant (P <0.05).4In120cases of coronary angiography in patients had serum chemokineand relative factors of Spearman correlation analysis revealed a positive serumChemerin levels in patients with coronary heart disease and coronary lesionvessels, r=0.794, P=0.000, P <0.05; Gensini score and positive correlation, r=0.666, P=0.000, P <0.05; positive correlation with high sensitive C reactionprotein, r=0.327, P=0.00, P <0.05; positive correlation with body mass index,r=0.225, P=0.013<0.05.5In120cases of coronary angiography in patients had serum chemokineand relative factors of Spearman correlation analysis showed that serum levelsof omentum was negatively correlated with the number of diseased coronaryvessels, r=-0.387, P=0.000, P <0.05. Gensini score; and negative correlation,r=-0.282, P=0.00, P <0.05; negative correlation with high sensitivity C reactive protein, r=-0.013, P=0.018, P <0.05; positive correlation with bodymass index, r=0.016, P=0.865, P>0.05, correlation between the serumomentin and BMI are not obviously statistical significance.6Serum analysis method has been undergoing coronary angiography of120cases with multiple linear stepwise regression trend of hormone level andthe correlation between body mass index, Gensini score, lesion vessels, highsensitive C reactive protein analysis, stepwise fitting,3variables selected intothe equation, the optimal regression equation is: Y=-109.574-2.338hypersensitive CRP+27.867lesion count of+1.010Gensini integral, thecoefficient of determination R2=0.696. Serum chemokines levels can beGensini score, lesion vessels, high sensitive C reactive protein explainaccounted for69.6%, other confounding and accidental factors accounted for30.4%. The results showed that, serum chemokine had linear regressionrelation and the number of coronary artery lesion, Gensini integral,high-sensitivity CRP, by the standard regression coefficient that, Gensiniintegral on serum tend to maximize the influence.7Correlation between serum retinal analysis method has beenundergoing coronary angiography of120cases with multiple linear stepwiseregression level and body mass index, Gensin score, lesion vessels, highsensitive C reactive protein analysis, stepwise fitting,3variables selected intothe equation, the optimal regression equation is: Y=756.558-36.697lesioncount+5.767hypersensitivity the CRP-2.060Gensin integral, the coefficient ofdetermination R2=0.290. Serum visfatin level by the Gensin integral, lesionvessels, high sensitive C reactive protein explain accounted for29%, otherconfounding and accidental factors accounted for71%. The results showedthat, there was a linear regression relationship among serum visfatin,coronarylesion vessels, Gensin integral amd high-sensitivity CRP, the standardregression coefficient shows that, the effects of lesion vessels pigment mostlyaffects serum retinal.Conclusion:1The serum omentin-1mostly affects the occurrence and development of the coronary heart disease, and is a protective factor.The protection ofSerum omentin-1for the development and occurance of unstable anginapectoris has no significant differences in acute ST segment elevationmyocardial infarction; The protection of Serum omentin-1for thedevelopment and occurance of acute ST segment elevation myocardialinfarction are stronger than in acute non-ST segment elevation myocardialinfarction.There is a close relationship between serum omentin-1and theprogress of myocardial infarction.2The serum omentin-1level and the disease severity of acute coronarysyndrome patients was negatively correlated.Acute coronary syndrome ofcoronary artery lesions in patients with more severe, the lower level of serumvisfatin-1.3serum chemokine is closely related with the occurrence anddevelopment of coronary heart disease, and it is the pathogenic factors.Serumchemokines plays a stronger ongpathogenic role in the development ofunstable angina pectoris than the acute myocardial infarction is.Serumchemokines in the development of acute ST segment elevation myocardialinfarction and acute non-ST segment elevation myocardial infarction did notplay a pathogenic role which have statistical significance.4The severity of lesions of Serum chemokines levels and acute coronarysyndrome patients was positively correlated.Namely, the more severe acutecoronary syndrome of coronary artery lesions in patients is, the lower level ofserum visfatin-1is.5Serum visfatin has linear relationship with the number of coronaryartery lesion, integration, high sensitivity CRP, and the effects of lesionvessels pigment on serum retinal has maximum.6Serum chemokines have linear regression relationship with coronarylesion vessels, integration, high sensitivity CRP, body mass index, and theintegral on serum tend to maximize the influence. |
PDF Full Text Request