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目的:验证血浆前蛋白转化酶枯草杆菌蛋白酶Kexin9型(PCSK9)水平与冠状动脉狭窄程度的相关性。方法:连续入选因心绞痛样胸痛和(或)运动试验阳性接受冠状动脉造影的患者243例,收集基线临床资料,采用ELISA方法检测血浆PCSK9水平。根据标准Gensini积分四分位法将患者分为3组(低分值组0~14,135例;中等分值组25~53,54例;高分值组≥54,54例),对PCSK9水平与冠状动脉狭窄程度的相关性进行分析。结果:与低分值组相比,高分值组患者PCSK9血浆水平显著升高(208.61、217.43、246.81ng/ml)。血浆PCSK9水平与Gensini积分呈正相关(r=0.191,P=0.003)。经多因素回归分析调整传统危险因素后,证实PCSK9是冠状动脉狭窄程度的独立危险因子(r=0.139,P=0.034)。另外,经非配对检验后发现多支冠状动脉狭窄的患者其PCSK9水平更高(P=0.011)。结论:血浆PCSK9水平与冠状动脉粥样硬化性狭窄的严重程度具有相关性。
Objective: To verify the correlation between the level of plasma protein convertase subtilisin Kexin9 (PCSK9) and the degree of coronary artery stenosis. Methods: A total of 243 consecutive patients with angina pectoris and / or exercise test were enrolled in the study. Baseline clinical data were collected and the level of plasma PCSK9 was detected by ELISA. Patients were divided into 3 groups according to the standard Gensini quadrant (0 to 14,135 in the low-score group, 25 to 53,54 in the middle-score group, and 54 or 54 in the high-score group) The degree of coronary artery stenosis was analyzed. Results: Plasma PCSK9 levels were significantly higher in patients with high scores (208.61, 217.43, 246.81 ng / ml) than those in the low-scores group. There was a positive correlation between plasma PCSK9 level and Gensini score (r = 0.191, P = 0.003). After adjustment for traditional risk factors by multivariate regression analysis, PCSK9 was confirmed as an independent risk factor for coronary artery stenosis (r = 0.139, P = 0.034). In addition, patients with multiple coronary stenoses were found to have higher PCSK9 levels after unpaired testing (P = 0.011). Conclusion: Plasma PCSK9 level is correlated with the severity of coronary atherosclerosis.