目的:研究糖尿病合并冠心病患者血清 Hcy、U A含量与冠脉斑块性质变化的相关性.方法:选择2013年5月~2017年6月期间在延安大学附属医院东关分院诊断为2型糖尿病并根据冠脉CT A结果分为合并冠心病的CHD+DM 组和不合并冠心病的DM 组,选择同期在延安大学附属医院东关分院体检的健康者作为对照组.测定血清中同型半胱氨酸(Hcy)、尿酸(U A)及血小板活化指标、蛋白酶指标的含量.结果:DM 组和CHD+ DM 组患者血清中 Hcy、UA、sSema4D、sP-selectin、sE-selectin、MMP1、MMP3、CatK、ADAMTS4的含量均显著高于对照组,Klotho、TIMP2的含量显著低于对照组;CHD+ DM 组患者血清中 Hcy、UA、sSema4D、sP-selectin、sE-selectin、MMP1、MMP3、CatK、AD-AMTS4的含量均显著高于DM 组,Klotho、TIMP2的含量显著低于DM 组;CHD+DM 组患者血清中sSema4D、sP-selectin、sE-selectin、MMP1、MMP3、CatK、ADAMTS4的含量与Hcy、UA含量呈正相关,Klotho、TIMP2的含量与Hcy、UA含量呈负相关.结论:糖尿病合并冠心病患者血清 Hcy、UA含量的异常升高能够促进血小板的活化、聚集以及斑块纤维帽的降解、斑块稳定性的降低.%Objective:To study the correlation of serum Hcy and UA contents with coronary plaque property changes in diabetic patients with coronary heart disease.Methods:Patients who were diagnosed with type 2 diabetes mellitus in Dongguan Branch of Yan'an University Affiliated Hospital between May 2013 and June 2017 were selected and divided into the CHD+DM group who were complicated by coronary heart disease and the DM group who were not complicated by coronary heart dis-ease according to the results of coronary CTA ,and the healthy subjects who received physical examination in Dongguan Branch of Yan'an University Affiliated Hospital during the same period were selected as control group .The contents of homocysteine (Hcy) ,uric acid (UA) ,platelet activation indexes and protease indexes in serum were measured .Results :Serum Hcy ,UA ,sSema4D ,sP-selectin ,sE-selectin ,MMP1 ,MMP3 ,CatK and ADAMTS4 contents of DM group and CHD + DM group were greatly higher than those of control group whereas Klotho and TIMP2 contents were greatly lower than those of control group ;serum Hcy ,UA ,sSema4D ,sP-selectin ,sE-selectin ,MMP1 ,MMP3 ,CatK and ADAMTS4 contents of CHD + DM group were greatly higher than those of DM group whereas Klotho and TIMP2 contents were greatly lower than those of DM group ;serum sSema4D ,sP-selectin ,sE-selectin ,MMP1 ,MMP3 ,CatK and ADAMTS4 contents of CHD + DM group were positively correlated with Hcy and UA contents while Klotho and TIMP2 contents were negatively correlated with Hcy and UA contents .Conclusions :The abnormal increase of serum Hcy and UA contents in diabetic patients with coronary heart disease can promote the activation and aggregation of platelet ,the degradation of plaque fibrous cap and the decrease of plaque stability .
展开▼
