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目的:明确冠心病(CHD)患者脂联素(APN)水平是否下降,确定低APN血症是否是CHD的危险因素及APN水平与CHD类型和心血管危险因素间的关系。方法:117例研究对象分为对照组(CO)、稳定型心绞痛组(SAP)和急性冠状动脉综合征(ACS)组。SAP、ACS组与CO组进行比较了解CHD患者APN水平;比较不同类型患者的APN水平以确定APN水平与CHD类型间的关系;经logistic回归分析确定低APN血症是否是CHD的危险因素;比较合并某一心血管危险因素者与不合并者的APN水平,了解心血管危险因素对APN水平的影响。结果:CO组、SAP组、ACS组3组比较APN呈降低趋势(10.61±3.38,6.98±3.18,4.59±3.69,P<0.05);逐步logistic回归分析结果显示低APN血症(OR值=0.788,p=0.041)、高胆固醇血症(OR值=5.096,p=0.009)为CHD患病的独立危险因素;超重或肥胖、血脂异常、男性、吸烟、合并3个及3个以上危险因素的CHD患者APN水平降低(P<0.05),合并高血压和糖尿病者APN水平无明显下降。结论:CHD患者APN水平下降,ACS患者APN水平较SAP患者进一步下降。低APN血症是CHD的危险因素。肥胖、吸烟、男性、血脂异常可使APN水平下降,且合并心血管危险因素多者APN水平进一步降低。
Objective: To determine if the level of adiponectin (APN) is decreased in patients with coronary heart disease (CHD), determine whether low APN is a risk factor for CHD and the relationship between APN level and CHD type and cardiovascular risk factors. Methods: 117 subjects were divided into control group (CO), stable angina pectoris group (SAP) and acute coronary syndrome (ACS) group. SAP, ACS group and CO group were compared to understand the level of APN in patients with CHD; APN levels were compared between different types of patients to determine the level of APN and CHD type; Logistic regression analysis to determine whether low APN is a risk factor for CHD; APN levels in patients with and without cardiovascular risk factors and to understand the impact of cardiovascular risk factors on APN levels. Results: The APN of CO group, SAP group and ACS group showed a decreasing trend (10.61 ± 3.38,6.98 ± 3.18,4.59 ± 3.69, P <0.05). The results of stepwise logistic regression analysis showed that the APN decreased (OR = 0.788 , p = 0.041), hypercholesterolemia (OR = 5.096, p = 0.009) was an independent risk factor for CHD; overweight or obesity, dyslipidemia, male, smoking, combined with 3 and more risk factors APN levels in patients with CHD decreased (P <0.05), APN levels in patients with hypertension and diabetes did not significantly decline. Conclusion: The level of APN is decreased in CHD patients and the level of APN in patients with ACS is lower than that in SAP patients. Low APN hyperlipidemia is a risk factor for CHD. Obesity, smoking, males, dyslipidemia can APN levels decreased, and more with cardiovascular risk factors APN levels were further reduced.