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目的:探讨冠心病患者血清瘦素水平变化及其与血小板膜GPⅠb的关系。方法:选择经冠状动脉造影确诊的冠心病患者50例(冠心病组)、非冠心病患者30例作为对照(对照组)。应用全血流式细胞术检测血小板膜GPⅠb阳性百分率及平均荧光强度,酶联免疫吸附法检测血清瘦素水平。结果:冠心病组血小板膜GPⅠb阳性百分率及平均荧光强度均低于对照组(P<0.05);校正收缩压、体质量指数(BMI)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖、2h血糖、空腹胰岛素水平及定量胰岛素敏感指数,冠心病组血清瘦素水平高于对照组(P<0.05);单因素相关分析表明冠心病患者血清瘦素水平与血小板膜GPⅠb平均荧光强度呈负相关(P<0.05);多元逐步回归分析显示冠心病患者血清瘦素水平与血小板膜GPⅠb平均荧光强度呈独立负相关(P<0.05);Logistic回归分析显示血清瘦素与冠心病发病呈独立正相关(P<0.05)。结论:冠心病患者表现为高瘦素血症,血清瘦素水平增高可能影响血小板活化,高瘦素血症可能在冠心病的发病中具有重要的作用。
Objective: To investigate the changes of serum leptin level in patients with coronary heart disease and its relationship with platelet membrane GP Ⅰ b. Methods: Fifty patients with coronary heart disease confirmed by coronary angiography (CHD group) and 30 non-CHD patients (control group) were selected. The GPIb positive percentage and mean fluorescence intensity of platelet membrane were detected by whole blood flow cytometry. Serum leptin level was detected by enzyme linked immunosorbent assay. Results: The GPIb positive rate and mean fluorescence intensity of platelet membrane in CHD group were lower than those in control group (P <0.05); systolic blood pressure, body mass index (BMI), low density lipoprotein cholesterol (LDL-C) (HDL-C), fasting blood glucose, 2h blood glucose, fasting insulin and insulin sensitivity index, serum leptin levels in CHD group were higher than those in control group (P <0.05). Single factor analysis showed that serum leptin (P <0.05). The multivariate stepwise regression analysis showed that the serum leptin level in patients with coronary heart disease was negatively and independently correlated with the average fluorescence intensity of platelet membrane GPⅠb (P <0.05). Logistic regression analysis Serum leptin showed a positive correlation with the incidence of coronary heart disease (P <0.05). Conclusion: Patients with coronary heart disease show hyperlipidemia. Elevated serum leptin level may affect platelet activation. Hyperleptinemia may play an important role in the pathogenesis of coronary heart disease.