【作者】 张小琼；

【导师】 范春雨； 吕吉元；

【作者基本信息】 山西医科大学 ， 心血管内科， 2012， 硕士

【摘要】 目的：①探讨不同类型的冠状动脉性心脏病(CHD)患者血清中骨保护素(OPG)和超敏C反应蛋白(hs-CRP)的水平,及其与冠状动脉病变程度的关系。②冠心病患者在使用阿托伐他汀钙片干预前后血清骨保护素(OPG)、超敏C反应蛋白(hs-CRP)水平的变化情况。方法：选取入住我院心内科的患者，按疾病严重程度分为急性冠脉综合征（ACS）组（n=30例）、稳定性心绞痛（SA）组(n=30例)及对照组（CO）组(n=10例)，检测并比较3组患者的血清中骨保护素（OPG）和超敏C反应蛋白（hs-CRP）表达水平的差异。其表达水平再与冠脉造影结果进行比对和分析。所有入选患者在给予阿托伐他汀钙片（20mg，一次/日）2周后再次检测3组患者血清OPG、hs-CRP的表达水平，并分析给药前后二者表达水平的差异。结果：①ACS组患者的血清OPG及hs-CRP表达水平明显高于SA组及CO组，而SA组血清OPG及hs-CRP的表达水平又高于CO组(P<0.01)，且血清中OPG与hs–CRP的含量均随着冠脉病变数目的增加而增高。②在冠心病患者的血清中，OPG水平的变化同hs-CRP水平呈正相关(r=0.875,P<0.01)。③在服用阿托伐他汀钙片2周后ACS组患者血清中OPG及hs-CRP表达水平较服药前明显降低，差别有统计学意义(P<0.05)；SA组血清hs-CRP下降也有统计学意义，而SA组患者中血清OPG水平有所下降，但变化无统计学意义(P＞0.05)；对照组血清OPG及hs-CRP变化均无统计学意义。结论：冠状动脉性心脏病患者的血清OPG表达水平随冠心病严重程度增加而升高,且与hs-CRP水平呈正相关,提示OPG系统可能通过干预血管炎症反应而参与了冠状动脉粥样硬化病变进程。应用阿托伐他汀的治疗明显降低了ACS组患者血清中OPG、hs-CRP的表达水平。更多还原

【Abstract】 Objective:①To analyses the relationship between the levels of serum osteoproteger (OPG), hyper sensitive C reactive protein (hs-CRP) and severity of coronary artery lesions.②Before and after Coronary heart disease patients taking atorvastatin, serum osteoproteger (OPG) and high sensitivity C-reactive protein (hs-CRP)change in the level.Methods:According pathogenetic condition,60cases of patients with CHD were divided into acute coronary syndrome groups (ACS)(30cases), stable angina pectoris groups(SA)(30cases)and control groups (CO)(10cases), the level of OPG and hs-CRP in serum were detected with enzyme linked immunosorbent assay way. the difference of expressiving and the resulting coronary angiography were contrasted. All patients were given atorvastatin calcium (20mg/day). after two weeks, the three groups of patients with expression levels of serum of OPG and hs-CRP was detected again.And analyze the differences in the levels of expression before and after drug delivery.Result:①The levels of Serum OPG and hs-CRP were significantly higher in ACS group than those in SA group and controls group (P<0.01). The levels of Serum OPG and hs-CRP was higherin SA group than the CO group (P<0.01). As the numbers o f diseased vessels increased, there was a significant increasing in serum OPG and hs-CRP levels (P<0.01).②A positive relation was found between OPG and hs-CRP (r=0.875, P<0.01). After two weeks of taking atorvastatin calcium, serum OPG and hs-CRP in patients with ACS significantly decreased, there are statistically significant (P<0.05). The decreasing of serum hs-CRP have also statistically significant in SA group,serum OPG levels decline in the SA group, but the changes was not statistically significant (P>0.05); the changes of serum OPG and hs-CRP were not statistically significant in control group.Conclusion:The levels of serum OPG and hs-CRP are associated with the stenosis degree of the coronary artery in patients with acute coronary syndrome. OPG system were involved in the process of coronary atherosclerotic lesionsmay through interfereing with vascular inflammation reaction. Atorvastatin calcium significantly reduces the serum of OPG and hs-CRP levels of patients with ACS.更多还原