| Objective:Cardiac syndrome X (CSX) refers to a set of clinical typical fatigue angina pectoris, electrocardiogram (ECG) or athletic flat test is positive, and a normal coronary angiography before and after ergonovine provocation tests, and rule out other cardiac disease syndrome.CSX syndrome includes a series of symptoms:insulin resistance, high insulin hematic disease, reduce glucose tolerance, abnormal lipid metabolism and blood pressure, etc.Based on the analysis of all kinds of literature, in the diagnosis of coronary heart disease without coronary angiography examination of patients, there are 15-45% of patients with cardiac syndrome X. Although CSX long-term prognosis is good, but the recent recurrence patients with chest pain have very high mortality rate.At present the pathogenesis of CSX still not very clear.Researchers have proposed various pathogenesis theory, one of the most widely accepted is micro vascular dysfunction, increased oxidative stress is one of the important conditions of endothelial dysfunction.Adropin is a composed of 76 amino acid secretory proteins, Adropin can reduce obesity-related metabolic disorders, and obesity assembled in often with hypertension, insulin resistance and dyslipidemia.Research pointed out that the low Adropin level is likely to be the risk index of the metabolic syndrome in obese patients, and is a independent risk factor for heart failure.Pentraxin 3 (PTX-3) is an acute phase reaction protein, the structure and function is similar to C-reactive protein (CRP), and it is closely related to the development of disease such as the body’s immune function disease, infectious disease, and coronary atherosclerosis heart disease.gamma glutamyl transpeptidase(GGT) plays a more and more important role in the pathophysiology and prognosis of cardiovascular disease (CVD).It is the indirect marker of the epithelial cells of the microvascular function decline, atherosclerosis and increased of oxidative stress.This study intends to detect the level of serum adropin,CysC, PTX-3, hs-CRP, GGT among Cardiac syndrome X (CSX), non Cardiac syndrome X and healthy controls, and comparison their difference in the three kinds, to explore the role of adropin Cystatin C (CysC), PTX-3, hs-CRP, GGT in the pathogenesis of cardiac syndrome X, in the hope of looking for its prevention and control of new evidence.Methods:1 Research objectFifity-three patients with cardiac syndrome X(CSX group) from inpatient and outpatient clinic patients in hebei medical university heart treatment center, from the October 2011-April 2013.This group consisted of 23 males and 30 females whose ranged from 46 to 74 years, (male 13 cases,female 40 cases, aged 46-74, the average age of 57.4±8.2 years), pathogenesis and diagnosis for an average of 2+/-2.5 years,diagnostic criteria:typical chest pain after exercise or overworked, sports load test results (such as angina pectoris can be repeated, ST segment down acuity 0.1 mv, etc.) and normal coronary angiography; 45 patients with NON-cardiac syndrome X(NCSX group) (20 cases were male, female 25 cases, age 44-73,mean age 63.1±8.9 years), patients with CSX group of similar age and sex, risk factors, but there was no typical fatigue angina pectoris, exercise load test negative, normal coronary angiography, and no sign of vasospasm.Choose the same health check-up 40 (20 cases of 20 cases, women, aged 45-78,average age 59.7±7.2) for the control group, without coronary heart disease risk factors, normal ecg and echocardiography.Three groups of patients with no difference in age and sex.Exclusion criteria:acute coronary syndrome or chronic myocardial infarction;All kinds of cardiomyopathy;Congestive heart failure.Diabetes;All sorts of valvular heart disease and various hepatitis, liver cirrhosis, kidney disease and infectious diseases and sepsis (sepsis shock,etc.);Leucocyte number and elevated hs-CRP (> 20 mg/L) of the patients.2 Test method(1) The level of serum Adropin, PTX-3 was detected:enzyme-linked immune method, according to the reagent instructions. All the test were in the secondary biological safety laboratory.(2) The levels of serum CysC, hs-CRP, GGT and the conventional biochemical indexes:GLU, TC, TG, HDL-C, LDL-C were detected by automatic biochemistry analyzer in the secondary biological safety laboratory for testing.(3) The results of Adropin,PTX-3 was performed by "Curve Expert 1.3" software, and the concentration of Adropin、PTX-3 in samples was calculated by the standard Curve. SPSS 17.0 statistical software was used for statistical analysis.Results:BMI, the levels of serum TG, TC, HD-C、LDL-C in CSX group and NCSX group were significantly higher than that in the control group, serum HDL-C level in CSX group and NCSX group was obviously lower than that in the control group. There was no significant diffierence between CSX group and NCSX group. The levels of Adropin in CSX group and NCSX group was significantly lower than that in the control group, while the Cystatin C level was higher than that in the control group. The levels of Adropin in CSX group was significantly lower than that in NCSX group, while the Cystatin C level was higher than that in NCSX group (P<0.05).Pearson collection analysis,serum Adropin level was negative correlated with the levels of TC、TG、LDL-c and CysC((r=-0.254,P=0.023 vs r=-0.503, P=0.000 vs r=-0.373,P=0.001vs r=-0.617,P=0.000)), was positive correlated with the level of HDL-c(r=0.398, P=0.000). Serum CysC level was positive correlated with the levels of TC、TG、LDL-c(r=0.411, P=0.000 vs r=0.528, P=0.000 vs r=0.512,P=0.000),was negative correlated with the level of HDL-c(r=-0.420, P=0.000). Conclusion The levels of serum Adropin and Cystatin C were controbuted to the pathogenesis of cardiac syndrome X. |
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