摘要
目的:通过检测急性冠状动脉综合征(ACS)患者血浆Fn和Fg水平,探讨其与不同类型冠心病及冠状动脉狭窄程度之间的相关性及临床意义。方法:选取接受冠状动脉造影检查的患者88例。其中,ACS患者47例(ACS组),稳定型心绞痛(SAP)患者18例(SAP组)和冠状动脉造影正常对照者23例(Control组)。采用酶联免疫吸附法(ELISA)分别检测患者外周血浆Fn水平,凝血酶比浊法测定血浆Fg水平。根据冠状动脉造影结果,分为单支病变组、双支病变组及3支病变组,并结合改良的Gensini冠状动脉病变积分标准分别比较血浆Fn和Fg水平变化与冠状动脉管腔病变程度的相关性。结果:ACS组血浆Fn和Fg水平显著高于SAP组(P<0.01、P<0.05)及Control组(均P<0.01),SAP组血浆Fn和Fg水平亦高于Control组(均P<0.05)。血浆Fn水平在冠状动脉单支病变组、双支病变组及3支病变组之间差异无统计学意义(均P>0.05),而血浆Fg水平在冠状动脉3支病变组明显高于单支病变组(P<0.05)和双支病变组(P<0.01)。线性相关分析表明,血浆Fn与Fg水平具有明显相关性(r=0.381,P<0.01),血浆Fg水平分别与改良Gensini积分(r=0.322,P<0.01),VLDL-C(r=0.267,P<0.05)和lgLp(a)(r=0.349,P<0.01)水平呈正相关,而与ApoA1(r=-0.324,P<0.01)水平呈明显负相关,其他指标之间均无明显相关性。以所有研究对象的血浆Fn均数为界点,分成Fn≥290.37mg/L组和Fn<290.37mg/L组,分析2组间吸烟史、家族史、高血压史和糖尿病史的关系,结果除糖尿病病史在2组中间差异具有显著性(P<0.05)外,其余3项在2组间差异均无统计学意义(P>0.05);多因素logistic回归分析表明,Fn和Fg是ACS的重要危险因子。结论:血浆Fn和Fg水平可能与不稳定的粥样硬化斑块破裂密切相关,参与了血栓形成的病理过程,对预测及早期诊断ACS具有一定的临床价值;血浆Fg水平可作为反映冠状动脉病变狭窄程度的重要指标,而血浆Fn水平却不能作为反映冠状动�
Objective：To observe the alteration of the levels of plasma fibronectin（Fn） and fibrinogen（Fg） in patients with acute coromry syrdrome（ACS）,and explore their relation with different types of coronary heart disease（CHD） and the severity of coronary stenosis.Method：Patients（n=88） who underwent coronary angiography（CAG） were selected,and divided into three groups：acute coronary syndrome group（ACS,n=47）,stable angina pectoris group（SAP,n =18）,normal control group（Control,n=23）.The levels of plasma Fn and Fg were measured by enzyme linked immunosorbent assay（ELISA） and immunity turbidimetry assay respectively.The severity of coronary stenosis was classified according to the standard method into one-,two-,or three-vessel disease and was estimated by calculation of the modified Gensini＇s score.The relationship between Fn,Fg and the modified Gensini score were analysed by pearson linear correlation.Result：The levels of plasma Fn and Fg were significantly increased in ACS group than that in SAP group（P0.01 and P0.05） and Control group（P0.01,P0.01）,moreover,the levels of plasma Fn and Fg were significantly increased in SAP group than that in Control group（P0.05,P0.05）.There were no significant difference of Fn in plasma among the groups of one-,two-,and three-vessel disease groups（all,P0.05）,however the level of plasma Fg was significantly increased in the group of patients with three vessel disease as compared to the other two groups.（P0.05 and P0.01）.The level of plasma Fn was positively correlated with the level of plasma Fg（r=0.381,P0.01）.The level of plasma Fg was positively correlated with modified Gensini＇s score（r=0.322,P0.01）,VLDLC（r=0.267,P0.05） and lgLp（a）（r=0.349,P0.01） levels,while the level of plasma Fg was negatively correlated with ApoA1（r=-0.324,P0.01） level,no correlation was found amomg other indexes according to pearson linear correlation analysis.Multiple logistic regression analysis revealed that Fn and Fg
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2011年第1期30-34,共5页
Journal of Clinical Cardiology
