目的 探讨血红素加氧酶-1(HO-1)、平均血小板体积(MPV)与冠状动脉粥样硬化性心脏病(冠心病)的相关性.方法 纳入2011年3月~2014年12月于北京市门头沟区医院心内科住院的患者292例,其中男性167例,女性125例,年龄34~90岁,平均年龄(64±12)岁.根据冠状动脉造影结果分为冠心病组(n=149)和对照组(n=143).冠心病组进一步分为单支病变组(38例)、双支病变组(46例)、多支病变组(65例).收集患者基础资料,包括病史(糖尿病、高血压等)、血压等,检测血糖、低密度脂蛋白胆固醇(LDL-C)、MPV、HO-1、同型半胱氨酸(Hcy)及高敏C反应蛋白(hs-CRP)等.结果 冠心病组吸烟比例、年龄、LDL-C、hs-CRP、Hcy高于对照组,差异有统计学意义(P均<0.05).冠心病组MPV、Gensini积分明显高于对照组,HO-1水平低于对照组,差异有统计学意义(P均<0.05).单支病变组、双支病变组、多支病变组MPV及Gensini积分呈升高趋势,HO-1呈降低趋势,差异有统计学意义(P均<0.05).冠心病患者HO-1与Gensini积分呈负相关(r=-0.952,P<0.01),MPV与Gensini积分呈正相关(r=0.881,P<0.01),HO-1与MPV呈负相关(r=-0.818,P<0.01).HO-1<70μg/L(OR=1.697,95%CI:1.476~1.912)、MPV>8.80 fL(OR=2.568,95%CI:1.876~3.246)及吸烟(OR=1.213,95%CI:1.012~1.423)是冠心病发病的影响因素.结论 冠心病患者HO-1、MPV增加,且与冠状动脉病变程度相关;HO-1、MPV是冠心病发病的影响因素.
Objective To investigate the correlation among heme oxygenase-1 (HO-1), mean platelet volume (MPV) and coronary heart disease (CHD).Methods The patients hospitalized in the Beijing Mentougou District Hospital (n=292, male 167, female 125, aged from 34 to 90 and average age=64±12) were chosen from Mar. 2011 to Dec. 2014. All patients were divided, according to the results of coronary angiography (CAG), into CHD group (n=149) and control group (n=143). The CHD group was divided again into 1-vessel lesion group (n=38), 2-vessel lesion group (n=46) and multi-vessel lesion group (n=65). The basic materials including medical history (diabetes, hypertension, etc.) and blood pressure were collected from the patients, and levels of blood sugar, low-density lipoprotein-cholesterol (LDL-C), MPV, HO-1, homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) were detected.Results The percentage of smoking patients, and age, LDL-C, hs-CRP and Hcy were higher in CHD group than those in control group (allP<0.05). The level of MPV and Gensini scores were significantly higher, and level of HO-1 was lower in CHD group than those in control group (allP<0.05). The level of MPV and Gensini scores showed an ascending trend, and level of HO-1 showed a descending trend in 1-vessel lesion group, 2-vessel lesion group and multi-vessel lesion group. The level of HO-1 was negatively correlated to Gensini scores (r=-0.952,P<0.01), level of MPV was positively correlated to Gensini scores (r=0.881,P<0.01), and level of HO-1 was negatively correlated to MPV (r=-0.818,P<0.01). HO-1<70 μg/L (OR=1.697, 95%CI: 1.476-1.912), MPV>8.80 fL(OR=2.568, 95%CI: 1.876-3.246) and smoking (OR=1.213, 95%CI: 1.012-1.423) were influence factors of CHD attack.Conclusion The level of HO-1 decreases and level of MPV increases in CHD patients, which is correlated to severity of coronary artery lesion. HO-1 and MPV are influence factors of CHD attack.