急性冠脉综合征患者PCI前后血浆Alarin和Leptin水平变化的意义

孙雪; 王虹; 梁浩; 高海超; 肖双; 杨拓; 柴立杰

doi:10.12125/j.chj.202101001

急性冠脉综合征患者PCI前后血浆Alarin和Leptin水平变化的意义

Significance of plasma alarin and leptin changes in patients with acute coronary syndrome pre-and pro-coronary intervention

摘要

摘要:
目的通过测定急性冠脉综合征（ACS）患者经皮冠状动脉介入治疗（PCI）前后血浆Alarin和瘦素（Leptin）的水平变化，探究两者的变化规律在ACS患者中的意义。
方法收集2019年12月～2020年12月期间于承德医学院附属医院行PCI治疗的ACS患者100例，分为急性心肌梗死（AMI）组46例，不稳定型心绞痛（UA）组54例，同期选取经冠脉造影检查证实无冠脉病变的患者33例为对照组，再根据Gensini评分体系将ACS患者分为A（Gensini评分>50分）、B（Gensini评分25-50分）、C（Gensini评分<25分）三组。采用酶联免疫测定所有患者术前5 min、术后24 h血浆Alarin及Leptin水平，比较各组患者基本临床资料及各实验室指标的差异，并分析Alarin、Leptin与Gensini评分的相关性。
结果与对照组相比，UA组性别和吸烟史统计数值均升高，统计学差异均为P<0.05；AMI组性别和吸烟史统计数值均升高，统计学差异分别为P<0.01和P<0.05，其余指标差异无统计学意义。AMI组与UA组术前与术后血浆Alarin与Leptin水平高于对照组（均P<0.01）。与本组术前比较，AMI组Alarin水平升高（P<0.05），Leptin水平升高（P<0.01），UA组Alarin水平升高（P<0.01），Leptin水平升高（P<0.05）。ACS患者术前、术后血浆Alarin与Leptin水平均呈正相关，且术前Alarin、术前Leptin、术后Leptin水平与Gensini评分呈正相关（均P<0.05）。比较各Gensini评分亚组血浆Alarin与Leptin水平变化。与C组比较，A组术前Alarin，术前术后Leptin升高（P<0.05）。与B组比较，A组术前Alarin，术前术后Leptin升高（P<0.05）。与本组术前比较，A B组Leptin及C组Alarin均升高（P<0.05）。
结论 ACS患者血浆Alarin与Leptin在PCI术后均有升高，两者可以很好地评估ACS患者的炎症严重状态，可用于评估PCI术后支架内再狭窄及冠状动脉新病变发生的可能。

Abstract:
AIM To determine the changes in plasma levels of alarin and leptin before and after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) and to explore the significance of their changes in ACS patients.
METHODS A total of 100 ACS patients who underwent PCI treatment in our hospital from August 2020 to October 2020 were collected and divided into AMI group (50 cases) and UA group (50 cases). At the same time, 50 patients with no coronary artery disease confirmed by coronary angiography wereselected as control group. According to the Gensini scores, the ACS patients were divided into three groups: A (Gensini scores>50 points), B (Gensini scores 25～50 points) and C (Gensini scores <25 points). Enzyme-linked immunosorbent assay was used to determine the plasma levels of alarin and leptin in all patients 5 minutes before and 48 hours after surgery. The differences in basic clinical data and laboratory indicators of each group were compared and the correlation between the alarin and leptin levels and the Gensini scores was analyzed.
RESULTS The levels of plasma alarin and leptin in AMI and UA groups were higher than those in control group at the same time point. The plasma alarin and leptin levels in AMI and UA groups after surgery were higher than those before the operation. The differences were statistically significant (All P<0.01). Preoperative and postoperative plasma alarin and leptin levels in ACS patients were positively correlated, and preoperative alarin and leptin levels as well as postoperative leptin level were positively correlated with Gensini scores (all P<0.05). The postoperative leptin levels in group A and group B was higher than those before operation, and the postoperative alarin level in group C was higher than that before operation. The difference was statistically significant (all P<0.05).
CONCLUSION Plasma alarin and leptin levels in ACS patients are elevated after PCI. In ACS patients, both can be used to assess the severity of inflammation and the possibility of in-stent restenosis and new coronary artery lesions after PCI.

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