血清PCSK9和MIF水平与冠心病患者冠状动脉病变程度的相关性

Correlation between PCSK9, MIF and the degree of coronary artery stenosis in patients with coronary heart disease

摘要:

目的]探讨血清前蛋白转化酶枯草溶菌素9(PCSK9)和巨噬细胞迁移抑制因子(MIF)水平与冠心病患者冠状动脉病变严重程度之间的关系。 [方法]对来自新疆维吾尔自治区人民医院2023年11月—2024年5月期间收治的冠心病患者(139例)及同期接受冠状动脉造影的对照者(69例)采取横断面研究。收集临床资料及冠状动脉造影结果,采用Gensini评分定量评估冠状动脉狭窄程度。根据Gensini评分将得分＞0分的患者按照三分位数分为:轻度狭窄组(1~18分,54例)、中度狭窄组(19~36分,54例)和重度狭窄组(＞36分,54例)。血清中PCSK9和MIF水平均采用ELISA试剂盒检测。 [结果]与对照组相比,冠心病组患者血清PCSK9和MIF水平显著升高(P＜0.05)。多因素Logistic回归分析显示高水平血清PCSK9和MIF均为冠心病的独立危险因素；Spearman相关性分析表明,血清PCSK9和MIF水平与Gensini评分呈正相关关系(r_s分别为0.619 6、0.411 4,均P＜0.001)；进一步亚组分析显示,高水平PCSK9患者的血清总胆固醇和低密度脂蛋白胆固醇水平显著升高,高水平MIF患者具有更高的全身炎症反应指数(SIRI)和系统性免疫炎症指数(SII)(均P＜0.05)。 [结论]血清PCSK9和MIF水平与冠状动脉狭窄程度均呈正相关,高水平血清PCSK9和MIF水平是冠心病的独立危险因素。

Abstract:

Aim To explore the relationship between serum levels of proprotein convertase subtilisin/kexin type 9 (PCSK9), macrophage migration inhibitory factor (MIF) and the severity of coronary artery lesions in patients with coronary heart disease (CHD). Methods A cross-sectional study was conducted involving 139 patients with CHD and 69 control subjects who underwent coronary angiography during the same period, all of whom were admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from November 2023 to May 2024. Clinical data and coronary angiography results were collected, and the severity of coronary artery stenosis was quantitatively assessed using the Gensini score. Patients with the Gensini scores＞0 were classified into three groups based on tertiles:the mild stenosis group (1～18 points, 54 cases), the moderate stenosis group (19～36 points, 54 cases), and the severe stenosis group (＞36 points, 54 cases). Serum levels of PCSK9 and MIF were measured by ELISA kit. Results Serum levels of PCSK9 and MIF were significantly higher in the CHD group than those in the control group (P＜0.05). Multivariable Logistic regression analysis revealed that high levels of serum PCSK9 and MIF were independent risk factors for CHD. Spearman correlation analysis showed that serum PCSK9 and MIF levels were positively correlated with Gensini score (r_s＝0.619 6 and r_s＝0.411 4, both P＜0.001). Further subgroup analysis showed that serum total cholesterol and low density lipoprotein cholesterol levels were significantly increased in patients with high-level PCSK9,while patients with high-level MIF had higher inflammatory coefficients such as systemic inflammatory response index (SIRI) and systemic immune-inflammation index (SII) (all P＜0.05). Conclusion Serum levels of PCSK9 and MIF are positively correlated with the severity of coronary artery stenosis. High levels of serum PCSK9 and MIF are independent risk factors for CHD.