| Objective:Coronary atherosclerotic heart disease is one of the diseases with the highest mortality world-wide. The underlying cause of the vast majority of coronary heart disease is coronary atherosclerosis. Atherosclerosis(AS) is a kind of chronic inflammation, Proliferative disease. Abnormal blood lipids play a key role in the atherosclerotic heart disease, It is the cornerstone of coronary atherosclerosis. Seeking a simple, fast, no treatment for invasive and reliable index to judge the degree of coronary artery stenosis and guide CHD has important clinical significance.Serum retinol binding protein-4(RBP4) is a recently discovered secreted by adipose cells of a noveladipocyte derived factor, It is involved in mediating the effects of chronic inflammation, glucose and lipid metabolism,promoteinsulin resistance(IR) and lead to heart obesity, these are the important risk factor of coronary heart disease. The severity of atherosclerosis and cardiovascular events correlated with the plasma levels of the relevant..The existing studies about RBP4 is the study of its and coronary artery disease and its mechanism,according to the study of RPB4 and the severity of coronary artery lesion less.At present, using a general quantitative Gensini integral method evaluation at home and abroad is widely usedfor the assessment of the severity of coronary artery lesion, he Gensini integral method of the integral method at the same time differences in the effects ofstenosis on the various vascular lesions and different branch and part of the myocardial blood supply can be evaluated, accurate, objective and comprehensive assessment of the severity of coronary artery lesions.The purpose of this study was to observe the patients by different selective coronary angiography and RBP4 value,and to investigate thecorrelation between RBP4 levels and the severity of coronary lesions in patients with coronary heart disease, prediction of RBP4 can be used as a moreeffective detection index judging disease. It can provide new ideas for prevention and treatment of cardiovascular disease.Methods:1 We take the 110 cases of patients from December 2012 to December2013 in the Third Hospital of Shijiazhuang,who came to treat in the Department of Cardiology.On the basis of clinical symptoms with coronary angiography results into coronary heart disease group of 75 cases and 35 cases of normal control group, CHD group was divided into stable anginapectoris(SAP) sub group 22 patients, unstable angina subgroup(UAP) 37 cases, acutemyocardial infarction(AMI) subgroup 16 cases, Age, gender, height were recorded, hypertension, smoking, weight ratio proportion, family history,general laboratory indices in patients with(cholesterol, glycerin three greases, high density lipoprotein, low density lipoprotein, creatinine, urea nitrogen, ESR) of each index. The standard set of diagnosis of coronary heart disease are in line with the American Heart Association(ACC) and the American Heart Association(AHA) diagnostic criteria, All patients diagnoses are tested by clinical and biochemical,ECG and selectively coronary angiography. All patients have never catched rheumatism, rheumatoid diseases,2-type diabete,acute and chronic inflammatory diseases, cancer,infectious diseases,autoimmune diseases,severe obesity, underweight, serious liver and kidney dysfunction,blood diseases,heart disease,valvular disease,and there are not clear cerebral vascular or peripheral vascular disease patients.2 After admission all patients on admission 24 h fasting venous blood was sampled 3ml above 10h(AMI and UAP of patients admitted to hospital immediately after extraction),and put into lithium heparin tubes,with shaking well. Within 2H to 3000r/min, the centrifugal separation blood 10 min, serum0.5ml and the upper layer is placed in the PPV tube-80 DEG C to be preserved, the same batch of samples by double antibody sandwichABC-ELISA method, detection of serum retinol binding protein-4(RBP4)concentration.3 The calculation of Gensini integral All through the radial artery using Judkins method of selective coronary angiography, recordingvessel disease, Gensini score was calculated according to the results of quantitatively evaluate the severity of coronary artery lesions.(Computational Methods:weight coefficient multiplied by the corresponding to the degree of stenosis of the parts of the scoreof each part of the sum integral).4 The correlation between RBP4 concentration levels were observed in patients with coronary angiography and Gensini integral. Statistically significant differences between the groups were compared between age,gender, general laboratory indexes.5 All quantitative data analysis used SPSS13.0 statistical Packages.Measurement data with?x 士 s representation; more than a few between the two groups were compared using single factor analysis of variance, LSD test was used to compare between the two groups; count data ?2 test was used to compare between the two groups.P<0.05 for significant difference,P<0.01 for the difference was significant.Results:1 Groups of age, gender, general laboratory index, have no statistical significance(P> 0.05)2 Serum RBP4 concentrations of SAP group(38.6 士 7.1mg/L),UAP group(47.8 士 8.4mg/L) and AMI group(62.5 士 11.8mg/L), are significantly higher matched group(30.5 士 7.5mg/L), there is singnificant statistical difference(P<0.05). And with the increase of Gensini scores,RBP4 increased inturn, there is singnificant statistical difference(P<0.05). there was a significant positive correlation between Gensini scores with serum retinol-binding protein4 concentrations(P<0.05).3 CHD group,the serum levels of RBP4 as the dependent variable,blood lipid indexes as independent variables,through simple linear correlation analysis showed that,levels of RBP4 and TG levels were positivelycorrelated(r=0.266,P<0.05),and LDL-C levels were positively correlated(r=0.148, P<0.05),HDL-C was negative correlation(r=-0.039,P<0.05).TC and RBP4 were not significantly correlated(r=-0.016, P<0.05).Conclusions:1 There was a positive correlation between serum RBP4 levels and the degree of coronary artery stenosis in patients with coronary heart disease,that is to say, the degree of coronary artery stenosis is heavier, the higher the level ofserum RBP4. It suggestes that RBP4 level can reflect the severity of coronary lesions in patients with coronary heart disease to a certain extent,and can be used as an effective index of judging coronary lesions.2 Serum RBP4 level was positively correlated with TG and LDL-C level,and HLD-C was negative.3 Serum RBP4 and LDL-C can be combined to evaluate CHD in clinical. |
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