摘要
目的研究血浆血栓前体蛋白(TpP)和血清P选择素(Ps)水平在急性冠状动脉(冠脉)综合征(ACS)患者中的动态变化,探讨两者对ACS的预测价值。方法收集136例受试人群的末梢血,其中包括45例急性心肌梗死(AMI,AMI组)和31例不稳定心绞痛(UA,UA组)、30例稳定心绞痛(SAP,SAP组)和30例健康者(正常对照组)。从ACS中选取AMI经冠脉内支架植入术(PCI术)开通罪犯血管者25例作为冠脉再通组,经药物治疗后冠脉未通者20例作为冠脉未通组,用酶联免疫分析法(ELISA)定量测定受试人群的血浆TpP水平和血清Ps水平。结果正常对照组血浆TpP水平为(1.7±1.5)μg/ml,血清Ps水平为(11.5±4.5)μg/ml,SAP组血浆TpP水平为(2.3±1.4)μg/ml,血清Ps水平为(13.6±3.4)μg/ml,UA组血浆TpP水平为(6.2±2.1)μg/ml,血清Ps水平为(27.7±15.3)μg/ml,AMI组血浆TpP水平为(22.8±9.1)μg/ml,血清Ps水平为(46.2±18.1)μg/ml。正常对照组及SAP组血浆TpP水平及血清Ps水平比较,差异无统计学意义(P>0.05);UA组及AMI组血浆TpP水平及血清Ps水平均显著高于正常对照组(P<0.01)。AMI组血浆TpP水平及血清Ps水平明显高于UA组(P<0.01)。AMI患者诊断即可患者血浆TpP水平为(22.8±9.1)μg/ml,血清Ps水平为(46.2±18.1)μg/ml,冠脉未通组血浆TpP水平为(19.3±7.4)μg/ml,血清Ps水平为(40.6±13.4)μg/ml,冠脉再通组血浆TpP水平为(9.8±7.1)μg/ml,血清Ps水平为(15.2±7.6)μg/ml。冠脉未通组与AMI患者诊断即刻时的血浆TpP和血清Ps水平比较差异均无统计学意义(P>0.05);冠脉开通组患者TpP和Ps水平明显低于AMI诊断明确即刻时及冠脉未通组,差异具有统计学意义(P<0.01)。结论 TpP和Ps水平的升高与ACS的发生及冠脉病变严重程度密切相关,可以作为判断ACS患者粥样斑块是否稳定以及观察病情变化的血清学指标之一,也可作为AMI冠脉再通治疗是否成功的间接观察指标之一。
Objective To research dynamic changes of plasma thrombus precursor protein （TpP） and serum P-selectin （Ps） in acute coronary syndrome （ACS） patients, and to investigate their predictive value for ACS. Methods Peripheral blood of 136 study subjects were collects, including 45 cases with acute myocardial ilffarction （AMI, AMI group）, 31 cases with unstable angina pectoris （UA, UA group）, 30 cases with stable angina pectoris （SAP, SAP group） and 30 healthy people （normal control group）. Among patients with ACS, there were 25 cases receiving percutaneous coronary intervention for culprit vessel open in AMI as coronary artery reflow group and 20 eases receiving drug therapy with failed coronary reflow as non-coronary artery reflow group. Enzyme- linked immuno sorbent assay （ELISA） was applied to detect plasma TpP and serum Ps levels in study subjects. Results The normal control group had plasma TpP level as （1.7 ± 1.5） μg/ml and serum Ps level as （11.5 ± 4.5） μg/ml. SAP group had plasma TpP level as （2.3 ± 1.4） μg/ml and serum Ps level as （13.6 ± 3.4） μg/ml. UA gorup had plasma TpP level as （6.2 ±2.1） μg/ml and serum Ps level as （27.7 ±15.3） μg/ml. AMI group had plasma TpP level as （22.8 ±911） μg/ml and serum Ps level as （46.2 ±18.1） μg/ml. There was no statistically significant difference of plasma TpP and serum Ps levels between the normal control group and SAP group （P〉0.05）. UA group and AMI group both had obviously higher plasma TpP and serum Ps levels than the normal control group （P〈0.01）. AMI group had much higher plasma TpP and serum Ps levels than UA group （P〈0.01）. Patients with immediately diagnosed AMI had plasma TpP level as （22.8 ± 9.1） μg/ml and serum Ps level as （46.2 ±18.1） μg/ml.The non-coronary artery re/low group had plasma TpP level as （19.3 ± 7.4） μg/ml and serum Ps level as （40.6 ±13.4） ~tg/ml, and the coronary artery reflow group had plasma TpP level as （9.8± 7.1） μg/m
出处
《中国实用医药》
2017年第4期12-14,共3页
China Practical Medicine
基金
沈阳市科技创新专项资金(项目编号:F14-158-9-27)
