目的 :分析组织激肽释放酶结合蛋白(kallistatin,KS)在冠心病患者血浆中水平的差异以及与Gensini评分的相关性,揭示血浆KS水平与冠状动脉病变严重程度的相关性。方法:选取151例行冠脉造影检查的患者作为研究对象,统计其临床数据及造影结果。(1)根据冠脉病变分支结果分成4组:正常对照组、单支病变组、双支病变组、三支病变组,应用ELISA法测定患者血浆中KS含量;(2)根据Gensini评分评估其冠脉病变程度,将患者分为4组:A组(0分)、B组(〉0~≤20分)、C组(〉20~≤40分)、D组(〉40~艽160分),两两比较各组间患者血中KS含量的差异,并探究KS水平与Gensini评分间的相关性。结果 :(1)根据冠脉病变分支结果分的4组中,血浆KS量分别为:对照组(95.35±32.00)μg/m L、单支病变组(78.19±25.27)μg/m L、双支病变组(66.19±25.93)μg/m L、三支病变组(51.84±23.26)μg/m L,各组间均具有统计学差异(P〈0.01),KS水平与冠脉病变支数呈负相关;(2)根据Gensini评分分的A、B、C、D 4组中,KS含量分别为(101.66±36.50)μg/m L、(77.73±25.13)μg/m L、(61.58±23.06)μg/m L、(53.80±23.92)μg/m L,KS含量在各组间的差异有统计学意义(P〈0.01);(3)KS含量与Gensini评分存在统计学上有显著的相关性(r=-0.371,P〈0.001)。结论:冠心病患者血浆KS含量明显低于正常人群,且KS含量与Gensini评分存在显著的相关性。提示KS可能作为一个潜在的血管保护因子参与动脉粥样硬化性心脏病的发生发展过程。
Objective:To analyze the differences of the levels of human tissue kallikrein(KS)-binding protein in plasma of coronary heart disease(CAD)patients,and evaluate the correlation between KS and the severity of coronary artery stenosis. Methods:A total of151 patients with coronary angiography were enrolled in this study. Their clinical data and results of coronary angiography were collected. Plasma KS were measured by ELISA. Patients were stratified into four groups according to the results of coronary angiography(single coronary artery stenosis,double coronary artery stenosis,triple coronaryartery stenosis and controls)and four groups according to Gensini score [A group(0),B group(0~≤20),C group(20~≤40),and D group(40~艽160)] at the second step. KS levels were compared between different groups and correlation analysis was made between KS and Gensini score. Results:(1)In the four groups which were stratified according to the results of coronary angiography,the levels of KS in control(95.35 ± 32)μg /m L were significantly higher compared with single coronary artery stenosis(78.19 ± 25.27)μg / m L,double coronary artery stenosis(66.19 ± 25.93)μg / m L,and triple coronary artery stenosis(51.84 ± 23.26)μg / m L. There were statistically significant differences among the four groups(P〈0.001).(2) In the four groups which were stratified according to Gensini score,the levels of KS were(101.66 ± 36.50)μg / m L,(77.73 ± 25.13)μg / m L,(61.58 ± 23.06)μg / m L,and(53.80 ± 23.92)μg / m L,respectively. There were statistically significant differences among the four groups(P〈0.001).(3) Futhermore,there was a significant negative correlation between plasma KS levels and the Gensini score(r=-0.371,P〈0.001). Conclusions:The plasma KS levels were remarkable lower in the groups of CAD compared with controls. It indicates a novel role of KS in the progress of coronary atherosclerosis and the development of CAD.