| Purpose: To investigate the association between serum immunoglobulin level and serum lipid components,and the association between serum immunoglobulin level,serum lipid index and severity of coronary atherosclerosis,so as to provide evidence for the study of the pathogenesis and development of atherosclerosis.Method: Patients who underwent coronary angiography in the department of cardiology,the second hospital of Tianjin medical university from January 2016 to July 2016 were selected as the study subjects.According to the results of coronary angiography,all the subjects were divided into the CHD group and non coronary heart disease group.Inclusion criteria:(1)Patients with suspected initial angina requiring coronary angiography;(2)The patient had not taken any lipid-lowering drugs;(3)Patients with diabetes and hypertension were treated with conventional drugs;(4)Patient informed consent.Exclusion criteria:(1)Patients with Cor pulmonale,valvular heart disease rheumatic heart disease,cardiomyopathy and other organic heart disease;(2)Patients with diseases that may affect blood lipid and immune function,such as acute and chronic infections,rheumatic diseases,severe liver and kidney dysfunction,thyroid diseases,and recent surgical history;(3)Pregnant and lactating women;(4)Patients with cerebrovascular diseases,consciousness or mental disorders;(5)People with diseases of the blood system;(6)Patients with malignant tumors who have received immunotherapy;(7)Patients who have been taking hormone drugs for a long time.SPSS20.0 statistical software was used to analyze the relevant indicators of case data of the two groups.Blood lipid indicators: Total cholesterol(TC),Triglycerides(TG),High-density lipoprotein cholesterol(HDL-C),Low-density lipoprotein cholesterol(LDL-C),Apolipoprotein AI(Apo AI),Apolipoprotein B(Apo B),Lipoprotein(a)(LP(a)).Calculate the ratio of LDL-C/HDL-C,Apo B/Apo AI;Immunoglobulins index: Immunoglobulin E(Ig E),Immunoglobulin A(Ig A),Immunoglobulin G(Ig G),Immunoglobulin M(Ig M);Hypersensitive c-reactive protein(hs-CRP).Analysis of risk factors or predictors of coronary heart disease using logistic regression,spearmen correlation test was used to analyze the correlation between immunoglobulin level and blood lipid level.The correlation between blood lipid content,immunoglobulin level and the number of coronary artery lesions and the degree of coronary artery stenosis was analyzed.Result:1.A total of 97 patients were selected,including 56 patients in coronary heart disease group and 41 patients in non coronary heart disease group.There were 13 cases of chronic coronary syndrome,43 cases of unstable angina in coronary heart disease group.There were no statistically significant differences in male ratio,age and stroke history between the two groups(P>0.05).The proportion of BMI,abdominal circumference,smoking history,drinking history,hypertension history and diabetes history in the coronary heart disease group was higher than that in the normal coronary artery group,and the difference was statistically significant(P<0.05).2.Blood routine comparison between the two groups,coronary heart disease group NEU、MON、HGB was significantly higher than that of non coronary heart disease group,with statistical difference(p<0.05),but WBC、LYM、EOS、BAS 、PLT indicators were not statistically different(p>0.05).3.There were statistically significant differences in blood biochemical indexes between the two groups in BUN,SCr and HCY(P<0.05),but no statistically significant differences in UA,FIB,ALB,GLO,ALT,AST,TBIL,DBIL and IBIL(P>0.05);the Blood lipid: LDL-C(the coronary heart disease group 3.39±0.82mmol/L vs non coronary heart disease group 3.00±0.64 mmol/L,P=0.012),HDL-C(the coronary heart disease group 0.87(0.77,0.99)mmol/L vs non coronary heart disease group 1.12(0.95,1.33)mmol/L,P<0.01),LDL-C/HDL-C(the coronary heart disease group3.91±1.02 vs non coronary heart disease group 2.81±0.93,P=0.001),Apo AI(the coronary heart disease group1.06±0.13 g/Lvs non coronary heart disease group 1.29±0.19 g/L,P<0.01),Apo B/Apo AI(the coronary heart disease group 1.00±0.18 vs non coronary heart disease group 0.80±0.19,P<0.01),LP(a)(the coronary heart disease group 205.90(105.28,362.52)mg/L vs non coronary heart disease group 125.80(83.50,150.85)mg/L,P=0.001),the difference was statistically significant;TG,TC,Apo B and other indicators were not statistically significant between the two groups.4.Comparing the humoral immunity and inflammatory indexes between the two groups,the levels of Ig E,Ig A and hs-CRP in the coronary heart disease group were significantly higher than those in non coronary heart disease group,which was statistically significant(P<0.01).There was no significant difference in Ig G and Ig M levels between the two groups(P>0.05).5.Multivariate Logistic regression analysis of statistically significant indicators in patients with CHD showed that Ig E,hs-CRP and LP(a)elevation were independent risk factors for CHD(P<0.05,OR>1).6.The correlation between blood lipid,immunoglobulin index and severity of coronary atherosclerosis was analyzed.There was a negative correlation between Ig E and HDL-C,Apo AI(r =-0.443,-0.556,P<0.01).There was a positive correlation between LP(a)and Ig E,Ig A(r = 0.525,0.304,P<0.01).There was a positive correlation between Ig E and MON(r = 0.284,P<0.01).There was a positive correlation between Ig A and BAS(r = 0.207,P<0.01).HDL-C was negatively correlated with the number of branches and the maximum degree of stenosis(r =-0.460,-0.428,p<0.01).LDL-C was positively correlated with the number of branches and the maximum degree of stenosis(r = 0.357,0.270,p<0.01).Apo AI was negatively correlated with the number of branches and the maximum degree of stenosis(r =-0.567,-0.549,p<0.01).LP(a)was positively correlated with the number of branches and the maximum degree of stenosis(r = 0.510,0.591,p<0.01).Ig E was positively correlated with the number of branches and the maximum degree of stenosis(r = 0.647,0.717,p<0.01).Ig A was positively correlated with the maximum degree of stenosis(r = 0.204,p<0.05).Hs-CRP was positively correlated with the number of branches and the maximum degree of stenosis(r = 0.534,0.587,p<0.01).The higher the level of LP(a)and Ig E,the more severe the stenosis of coronary lesions,suggesting that LP(a)and Ig E can predict the severity of coronary atherosclerosis.Conclusion: Ig E level of coronary heart disease patients increased significantly,the Ig E level increased with coronary artery disease branch number,coronary artery disease maximum stenosis degree showed significant positive correlation,Ig E and LP(a)showed linear positive correlation,and blood mononuclear cell absolute value was positive correlation,but there was no significant correlation between Ig E and LDL-C;therefore,this study suggests that Ig E may serve as a residual cardiovascular risk other than LDL-C,or as an alternative endpoint for future intensive lipid-lowering therapy and reversing atherosclerotic plaques. |
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