«上一篇/Previous Article|本期目录/Table of Contents|下一篇/Next Article»

《慢性病学杂志》[ISSN:1674-8166/CN:11-5900/R]

卷:

期数:

2014年07期

页码:

511-513

栏目:

论著

出版日期:

2014-08-31

文章信息/Info

Title:

P-selectin levels analysis in patients with acute coronary syndromes

作者:

王志军;  张志强;  张放;  黄宇玲;  杨文琦;  刁增利;  刘铁楠;  李素新

河北联合大学附属医院心内科，河北唐山063000

Author(s):

WANG Zhi-jun;  ZHANG Zhi-qiang;  ZHANG Fang;  HUANG Yu-ling;  YANG Wen-qi;  DIAO Zeng-li;  LIU Tie-nan;  LI Su-xin

Department of Cardiology, Affiliated Hospital of Hebei united University, Tangshan,Hebei 063000, China Corresponding author:WANG Zhi-jun,E-mail:wzj300@163.com

关键词:

急性冠状动脉综合征; P 选择素; Gensini 评分; 主要不良心脏事件

Keywords:

Acute coronary syndrome;  P-selectin; Gensini socre;  Major adverse cardiac events

分类号:

R541.4

DOI:

-

摘要:

目的分析P 选择素（P- selectin， PS） 水平与急性冠状动脉综合征（acute coronary syndrome， ACS） 患者冠状动脉狭窄程度及6 个月主要不良心脏事件(major adverse cardiac events，MACE)的关系。 方法选取262 例以胸痛入院的患者，入院时抽肘静脉血化验P 选择素，均行冠状动脉造影检查，根据造 影结果、心电图及心肌酶结果将入选人群分为对照组(非冠心病患者)24 例、不稳定型心绞痛（UAP） 组 147 例及急性心肌梗死（AMI） 组91 例。根据冠状动脉造影结果行Gensini 评分，评价狭窄程度。随访6 个月，追踪患者MACE 事件的发生。应用SPSS 13.0 进行统计分析，比较各组间P 选择素水平差异。结 果对照组与ACS 组PS 水平分别为（14.59 ± 2.96）、（41.57 ± 11.89） ng/ml， 差异有统计学意义（P< 0.01）；UAP 组和AMI 组分别为（38.15±10.90）、（47.09±11.89） ng/ml，均高于对照组，且UAP 和AMI 组间差异亦有统计学意义（P<0.01）； ACS 患者PS 水平与冠状动脉Gensini 评分呈显著的正相关（r= 0.659， P<0.01）。冠状动脉单支病变、双支病变、三支病变的ACS 患者PS 水平分别为（32.68±10.02）、 （43.30±9.57）、（51.39±10.04） ng/ml，两两比较差异均有统计学意义（P<0.01）；MACE 组与非MACE 组 PS 水平分别为（52.95±8.87）、（36.38±13.10） ng/ml，差异有统计学意义（P＜0.01）。结论PS 水平检 测有助于ACS 患者的早期诊断、病情及预后评估。

Abstract:

Objective To evaluate the relationship between plasma P-selectin (PS) levels and the degree of coronary artery stenosis, major adverse cardiac events (MACE) were followed up for six months in acute coronary syndrome (ACS) patients. Methods A total of 262 hospitalized patients with chest pain were selected as the research objects. Plasma PS levels were measured and coronary angiography examination were performed. Based on the results of coronary angiography, ECG and levels of myocardial enzymes, the patients were divided into three groups: control (n=24, without coronary heart disease), unstable angina (UAP) (n=147) and acute myocardial infarction (AMI) (n=91). All patients were examined for coronary angiography and their Gensini scores were calculated. Patients were followed up 6 months to track MACE events. SPSS13.0 was used for statistical analysis. Results PS levels of the control and ACS group were （14.59±2.96） and （41.57±11.89） ng/ml, respectively, and were significant different (P<0.01). PS levels of the UAP and AMI group were, （38.15±10.90） and （47.09±11.89） ng/ml, respectively, each significantly higher than the control PS level (P<0.01). There was a positive correlation between PS level and Gensini score in ACS patients. PS levels in ACS patients with single coronary artery lesions, the double branch lesion and three lesions were （32.68±10.02）, （43.30±9.57） and（51.39±10.04） ng/ml, and there were significant differences between them. After six month follow-up, the PS levels of MACE group and no MACE group was （52.95±8.87） and （36.38±13.10） ng/ml and the difference was significant (P<0.01). Conclusions Detection of PS level facilitates early diagnosis and evaluation of severity and prognosis in patients with ACS.

参考文献/References:

[1] Robinson SD, Harding SA, Cummins P, et al. Functional in? terplay between platelet activation and endothehal dysfunction in patients with coronary heart disease ［J］．Platelets, 2006,17 (3):158-162.
[2］ Gensini GG. A more meaningful score for determining the se? verity of coronary heart disease ［J］．Am J Cardiol, 1983,51: 606.
[3］ 耿家峰.冠心病的危险因素及进展［J］． 医学综述,2011,17 (15):2310-2312.
[4］ Lowe GD. Local inflammation, endothelial dysfunction and fi? brinplysis in coronary heart disease ［J］． Clin Sci, 2006,110: 327-328.
[5］ Venturinelli ML, Hovnan A, Soeiro Ade M, et al. Platelet ac? tivation in different elinical forms of the coronary artery disease (role of P- selection and others platelet markers in stable and slableangina) ［J］．Arq Bras Cardiol, 2006,87(4):446-450.
[6］ Yip HK, Sun CK, Chang LT, et al. Strong corrlelation be? tween serum levels of inflammatory mediators and their distri? bution in infarctreluted coronary ［J］．Cire J, 2006,70(7):838- 845.
[7］ Futh R, Dinh W, Bansemir L, et al. Soluble P- selectin and matrix metalloproteinase 2 levels are elevated in patients with diastolic dysfunction independent of glucose metabolism disor? der or coronary artery disease ［J］． Exp Clin Cardiol, 2009, 14:76-79.
[8］ Yazici M, Demircan S, Duran K, et al. Relationship between myocardial injury and soluble P-selection in non-ST elevation acute eoronary syndromes ［J］．Cire J, 2005,69:530-535.
[9］ Fuman MI, Benoit SE, Bamard UR, et al. Increased platelet reactivity and circulation monolyte- platelet aggregates in pa? tients with stable coronary artery disease ［J］．J Am Coll Car? diol, 1999,31:352-358.
[10］ Mega JL, Morrow DA, et al. Thrombus precursor protein and elinical ouleomes in patients with acute coronary syndromes ［J］ . J Am coll Cardio, 2008,51(25):2422-2429.
[11］ Chiu CA, Wu CJ, Yang CH, et al. Levels and value of solu? ble P- selection following acute myocardial infaretion： evalu? ating the link between soluble P- selection levels and recruit? ment of circulating white blood cells and the marker for the rap? id diagnosis of chest pain ［J］． Chang Gung Med, 2005,28 (10):699-707.
[12］ 黄山,许健,令狐颖,等.P-选择素检测在急性冠状动脉综合征 诊断中的应用［J］．中国热带医学,2010,10(12):1514-1515.
[13］ 李霞,牛凡.P-选择素、胱抑素C 水平与冠心病病变程度的相 关性研究［J］．中西医结合心脑血管病杂志,2012,10(5):536- 537.
[14］ 屈晓冰,孙振球,陈美娟,等.冠心病患者P-选择素水平及其与 冠状动脉病变程度间的关系［J］．中华流行病学杂志,2005, 26(8):617-621.
[15］ Baeza VR, Corbalan HR, Castro GP, et al. Coronary bio? markers and long- term clinical outcome in ACS without ST segment elevation ［J］． Rev Med Chil, 2005,133(11):1285- 1293.
[16］ 赵顺锋.冠心病患者外周血单核细胞TLR4 表达及其与血浆P 选择素水平的相关性研究［J］．中华微生物学和免疫学杂志, 2011,31(4):320-321.

备注/Memo

备注/Memo:

基金项目：河北省卫生厅基金资助项目（20100474） 作者简介：王志军，博士，主任医师，主要从事心血管疾病诊治工作 通信作者：王志军，E-mail: wzj300@163.com

常用功能

更新日期/Last Update: 2014-08-30