目的 探讨视黄醇结合蛋白4(RBP4)和肿瘤坏死因子-α(TNF-α)水平与冠心病、冠脉病变程度的关系以及冠心病患者血浆RBP4和TNF-α 两者之间的相关性.方法 选择2015年12月—2017年2月至该院就诊并诊断为冠心病的90例患者临床资料.根据临床特点及结合冠脉造影的结果 分为:稳定型心绞痛(SAP)组28例、不稳定型心绞痛(UAP)组30例、急性心梗(AMI)组32例,另选该院体检健康者30例作为对照组;根据冠脉造影结果再将UAP组和AMI组患者分为单支病变组19例,双支病变组21例,三支病变组22例.采用酶联免疫吸附试验法(ELISA)检测各组患者血浆RBP4、TNF-α 的水平,分析冠心病不同类型及冠脉病变不同程度患者血浆中RBP4、TNF-α 变化趋势及两者之间的相关性,并采用SPSS17.0统计软件对所得数据进行分析.结果RBP4及TNF-α 水平在AMI、UAP、SAP及对照组四组间存在明显差异(P<0.05);RBP4与TNF-α 血浆水平在双支病变组与单支病变组及三支病变组与双支病变组相比呈现升高趋势,但三组血浆RBP4水平差异无统计学意义(P>0.05)、TNF-α 水平存在明显差异(P<0.05);冠心病患者血浆RBP4与TNF-α 血浆水平呈正相关(r=0.906,P<0.001).结论 RBP4及TNF-α 可视为冠心病的重要危险因素,可反映冠心病及冠脉病变的严重程度.冠心病患者血浆RBP4与TNF-α 水平相关,提示RBP4可能通过调节炎性反应,参与冠心病的发生、发展.%Objective To investigate the relationship of retinol binding protein 4 (RBP4) and tumor necrosis factor alpha (TNF-al-pha) on coronary heart diseaseand the severity of coronary artery disease. Methods The clinical data of 90 patients with coronary heart disease in the Second Affiliated Hospital of Shenyang Medical College from December 2015 to February 2017 were selected and assigned intostable angina pectoris (SAP) group of 28 cases,unstable angina pectoris (UAP) groupof 30 cases,acute myocardial in-farction (AMI) group of 32 cases according to the clinical features and the results of coronary angiography. In addition,30 healthy sub-jectswere selected as control group. According to the results of angiography,patients with unstable angina pectoris (UAP) and acute my-ocardial infarction (AMI) were assigned into single vessel lesion group of 19 cases,double vessel disease group of 21 cases,three vessel disease group of 22 cases. Enzyme linked immunosorbent assay (Elisa) was used to detect the levels of plasma RBP4 and TNF-alpha in each group. The changes of RBP4 and TNF-alpha in plasma of patients with different types of coronary heart disease and coronary artery lesions were analyzed. The data were analyzed by SPSS17. 0 statistical software. Results The levels of RBP4 and TNF-alpha in AMI, UAP,SAP and control group were significantly different (P < 0. 05) between the four groups. The levels of RBP4 and TNF-alpha plas-ma in the double vessel lesion group compared with the single vessel disease group and the three vessel disease group compared with the double vessel disease grouphadan increasing trend. However,there was no significant difference in plasma RBP4 level between the three groups (P > 0. 05). There was only significant difference in TNF-alpha level between the three groups(P < 0. 05). Plasma RBP4 level was positively correlated with plasma TNF-alpha level (r = 0. 906,P < 0. 001) in patients with coronary heart disease (CHD). Conclu-sions RBP4 and TNF-alpha can be regarded as theimportant risk factors for coronary heart disease,which can reflect the severity of coronary heart disease and coronary artery disease. The correlation between plasma RBP4 level and TNF-alpha level in patients with cor-onary heart disease (CHD) suggests that RBP4 may be involved in the occurrence and development of coronary heart disease (CHD).
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