D-二聚体与冠心病病情及冠状动脉病变稳定性的相关研究

The correlation of the plasma D-dimer with condition of patients with coronary heart disease and the stability of coronary lesions

目的 :探讨血浆D 二聚体 (D dimer,DD)与冠心病(CHD)病情及冠状动脉病变稳定性的关系。方法 :对 1 1 0例观察对象按照冠状动脉造影病变形态学特征分为 :简单病变组 3 2例 ,复杂病变组 5 6例 ,正常对照组 2 2例。同时 ,根据临床CHD病情分为 :急性心肌梗死 (AMI)组 1 1例、不稳定型心绞痛 (UAP)组 49例 ,稳定型心绞痛(SAP)组 2 8例 ,正常对照组 2 2例。用酶免法 (ELASA)检测血浆DD含量 ,比较不同组间DD含量。结果 :血浆DD含量复杂病变组 [( 0 .499± 0 .2 1 4)mg/L]高于简单病变组 [( 0 .3 2 9± 0 .1 73 )mg/L]及正常对照组 [( 0 .3 1 9± 0 .1 2 6)mg/L],差异均有统计学意义 (P <0 .0 1 )。AMI组 [( 0 .5 93± 0 .3 44 )mg/L]和UAP组 [( 0 .471± 0 .2 1 4)mg/L]明显高于SAP组 [( 0 .2 92±0 .1 0 1 )mg/L]及正常对照组 [( 0 .3 1 9± 0 .1 2 6)mg/L],差异均有统计学意义 (P <0 .0 1 )。结论 :血浆DD含量与冠状动脉病变稳定性及CHD病情严重性相关 ,DD是冠状动脉病变活动性的血液标志物。

Objective: To investigate the correlation between plasma D-dimer (DD) concentration and the condition of patients with coronary heart disease (CHD)and the stability of coronary lesions. Method:One hundred and ten subjects were divided into groups according to coronary angiography and clinical manifestation including 32 patients with simple lesions , 56 patients with complex lesions, 11 acute myocardial infarction (AMI), 49 unstable angina pectoris (UAP), 28 stable angina pectoris (SAP) and 22 normal healthy control subjects. Plasma DD concentrations were determined by ELASA, and then they were compared between the groups. Result:Plasma concentrations of DD were higher in patients with complex lesion ( 0.499± 0.214)mg/L than in those with simple lesions ( 0.329± 0.173)mg/L (P< 0.01 ), and higher in AMI group ( 0.593± 0.344)mg/L and UAP group ( 0.471± 0.214) than in SAP group ( 0.292± 0.101)mg/L (P< 0.01) and healthy control group ( 0.319± 0.126)mg/L (P< 0.01). Conclusion: Plasma DD concentrations are related with the stability of coronary lesions as well as the severity of CHD. DD may be a marker of coronary unstabilily.