| BackgroundCoronary heart disease and diabetes has become the top disease to threat human health, coronary heart disease in adults with diabetes was55%. In2002, the American Diabetes Association has command the diabetes as a coronary heart disease risk "equivalent", is a major risk factor for coronary heart disease, together with hypertension, dyslipidemia, smoking. Clinical practice show patients with coronary heart disease combined diabetes that coronary artery lesions appear as early and rapid progress, the lesions diffuse、hyperplasia and calcification severe,so that stent implantation and restenosis rate is very high, but the exact mechanism is not yet fully understood. The case of diabetes induced arterial atherosclerosis etiology complex, including glucose metabolism, lipid metabolism and endothelial dysfunction. But the long-term hyperglycemic state to produce excessive cell growth factors and inflammatory cytokines, the signaling pathways that regulate cell migration abnormalities, that may be concerned with the serious degree of coronary lesions in patients with coronary heart disease combined diabetes, research reported that, LR11is a members of the family of low density lipoprotein receptor(LDLR) to play an important role in the migration and proliferation of vascular smooth muscle cells (SMCs). Foreign research reports, in atherosclerosis patients serum sLRll concentration increased, to infer that sLRll might be involved in the formation of atherosclerosis, but the serum sLRll level elevated is related to the degree of coronary lesions in patients with coronary heart disease combined diabetes mellitus has not been reported. This study through the detection of patients with coronary heart disease combined with diabetes mellitus the serum sLRll level changes and the results of coronary angiography correlation analysis, designed to discuss coronary heart disease patients with diabetes mellitus the serum sLRll level with coronary lesion degree of relationship.ObjectiveThis study test the serum sLRll level of coronary heart disease patients with diabetes mellitus, to discusses the role of sLRll in the coronary heart disease patients with diabetes mellitus, Combined with coronary angiography (CAG) results to count the number of coronary lesions blood vessels, using the the Gensini scoring criteria to assess the narrow scope and extent of coronary lesions. To discusses the serum level of sLRll in patients with coronary heart disease combined diabetes and its relationship with coronary lesion severity and clinical significance.MethodsSelect102patients from October2011to May2012in the Department of Cardiology of the First Affiliated Hospital of Zheng Zhou University, all the patients were divided into three groups:25case of control group,16males and9females, age (57.41±7.25) years old,48case of simple coronary heart disease group48:36males,12females, age (66.52±9.75) years old,29case of Coronary heart disease with diabetes group:20males and9females, age (62.42±9.62) years old.. According to coronary angiography, the result is negative included in the control group; The standard of the simple coronary heart disease group:Selective coronary angiography left main coronary artery stenosis＞30%, or three of at least one coronary artery stenosis＞50%; The standard of coronary heart disease patients with diabetes mellitus group; Selective coronary angiography left main coronary artery stenosis＞30%, or three of at least one coronary artery stenosis＞50%and according to the1999WHO diagnostic criteria for diabetes. All enrolled study patients fasting12s cubital vein blood3～5ml dry test tube,3000r/min centrifugal lOmin after serum,-80℃save under test. Fasting plasma glucose (FPG), glycosylated hemoglobin (HbAlc), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDLC), high-density lipoprotein cholesterol (HDLC) and other biochemical markers hospital clinical inspection Center automatic biochemical analyzer measurement. Through ELIS A concentration of serum sLR11. The extent of coronary lesions Gensini scores judgment.The application SPSS17.0statistical package for statistical analysis, data normality test first, the normal distribution of measurement data to mean±standard deviation (χ±s) between the two groups were compared using the t test, multiple sets of between the average number was used to compare the one-way ANOVA, significant differences among the groups on the basis of pairwise comparison t test. Normal distribution data correlation analysis using Pearson linear correlation, correlation analysis of non-normal distribution of information to adopt Speaman rank correlation.To P＜0.05for difference have statistical significance.Results1. In Control group, Simple coronary heart disease group and coronary heart disease with diabetes group there is not significant difference in age, gender, smoking history, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), total cholesterol(TC), low density lipoprotein (LDL-C), high-density lipoprotein cholesterol (HDL-C)(P＞0.05). Fasting glucose (FPG) and glycosylated hemoglobin (HbAlc) in coronary heart disease with diabetes group and simple coronary heart disease group were higher than control group, difference has statistical significance (P＜0.05).Fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) there is no statistically significant difference in control group and simple coronary heart disease group (P>0.05).2. The serum level of sLR11in Simple coronary heart disease group(17.67±2.70) and coronary heart disease with diabetes group(34.12±5.84) significantly higher than that in the control group(6.32±2.47), the difference was statistically significant (P＜0.05,P＜0.01). The serum levels of sLRll and Gensini score in coronary heart disease combined with diabetes group higher than the Simple coronary heart disease group, the difference was statistically significant (P＜0.05). Coronary heart disease with diabetes group (r=0.816, P＜0.01) and simple coronary heart disease group (r=0.759, P＜0.01) serum sLRll level was positively correlated with the Gensini score. Coronary artery disease patients with diabetes mellitus the serum sLRll level of HbAlc was positively correlated (r=0.823,p＜0.01).Conclusions1. Coronary heart disease patients with diabetes mellitus and serum sLRll level is simply a significant rise in coronary heart disease group and control group, and sLRll with HbAlc levels were positively correlated.2. Elevated levels of serum sLRll coronary heart disease patients with diabetes mellitus and coronary artery stenosis severity are closely related,3. The serum level of sLRll may be evaluating coronary heart disease patients with diabetes mellitus coronary artery lesion severity new prediction markers, and provide scientific basis for looking for effective treatment. |
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