目的:探讨血清成纤维细胞生长因子21(FGF21)、核转录过氧化酶增殖体激活受体γ(PPARγ)与冠状动脉狭窄(CAS)的相关性。方法:遴选60例冠心病(CHD)患者为CHD组,30例健康体检人群为对照组,测定两组血清FGF21及PPARγ水平。所有受试者采用Gensini评分法对CAS程度进行量化评分,进而探讨FGF21、PPARγ与CAS之间的关系。结果:冠状动脉造影显示,CHD组单支病变26例,双支病变19例,三支病变15例;CHD组FGF21、PPARγ水平明显高于对照组(P＜0.05);三支病变者FGF21、PPARγ水平高于双支病变者(P＜0.05),显著高于单支病变者(P＜0.01);双支病变者FGF21、PPARγ水平高于单支病变者(P＜0.05)。按Gensini评分分组后,0～1分组FGF21、PPARγ水平最低,大于40分组FGF21、PPARγ水平最高,21～40分组和＞40分组FGF21、PPARγ水平均高于2～20分组(P＜0.05)。偏相关分析显示,血清FGF21与CAS病变支数呈正相关(r=0.472,P＜0.05),与Gensini评分呈正相关(r=0.516,P＜0.05);PPARγ与CAS病变支数呈正相关(r=0.368,P＜0.05),与Gensini评分呈正相关(r=0.335,P＜0.05)。Spearman相关分析显示,FGF21与PPARγ间呈正相关(r=0.412,P＜0.05)。ROC曲线分析提示血清FGF21浓度与CHD有正相关性(P＜0.05)。结论:冠心病患者血清FGF21与PPARγ水平高于健康人群,且与冠状动脉狭窄程度呈正相关,二者可预测和评估冠状动脉病变的严重程度。

Objective: To investigate the correlation between serum fibroblast growth factor 21 (FGF21), proliferator-activated receptor γ (PPARγ) and coronary artery stenosis (CAS). Methods: A total of 60 patients with coronary heart disease (CHD) were selected as CHD group and 30 healthy subjects were selected as control group. Serum FGF21 and PPARγ levels were measured in both groups. All subjects were quantified by Gensini scoring method for CAS degree, and then the relationship between FGF21, PPARγ and CAS was discussed. Results: Coronary angiography showed that there were 26 cases of single vessel disease, 19 cases of double vessel disease and 15 cases of triple vessel disease in CHD group. The levels of FGF21 and PPARγ in CHD group were significantly higher than those in control group (P＜0.05). The levels of FGF21 and PPARγ in patients with three-branch disease were higher than those in patients with two-branch disease (P＜0.05), and significantly higher than those in patients with single-branch disease (P＜0.01). The levels of FGF21 and PPARγ in patients with double-branch disease were higher than those in patients with single-branch disease (P＜0.05). After grouping by Gensini score, the levels of FGF21 and PPARγ in groups 0 to 1 were the lowest, the levels of FGF21 and PPARγ in groups greater than 40 were the highest, and the levels of FGF21 and PPARγ in groups 21 to 40 and > 40 were higher than those in groups 2 to 20 (P＜0.05). Partial correlation analysis showed that serum FGF21 was positively correlated with the number of CAS lesions (r=0.472, P＜0.05), and with Gensini score (r=0.516, P＜0.05). PPARγ was positively correlated with the number of CAS lesions (r=0.368, P＜0.05) and with Gensini score (r=0.335, P＜0.05). Spearman correlation analysis showed that there was a positive correlation between FGF21 and PPARγ (r=0.412, P＜0.05). ROC curve analysis indicated that serum FGF21 concentration was positively correlated with CHD (P＜0.05). Conclusion: Serum FGF21 and PPARγ levels in CHD patients were higher than those in healthy people, and were positively correlated with the degree of coronary artery stenosis, which may predict and evaluate the severity of coronary artery disease.