维生素E对组织因子及其抑制物在冠心病中的干预作用

Effect of vitamine E with tissue factor and tissue factor pathway inhibitor on coronary heart disease

目的 :探讨冠心病 (CHD)的不同类型中血浆组织因子 (TF)及其抑制物 (TFPI)含量的差异变化及维生素E对急性心肌梗死 (AMI)干预作用。方法 :用ELISA方法检测CHD患者 [包括稳定型心绞痛 (SAP)、不稳定型心绞痛 (UAP)、AMI]入院时及治疗 2周时血浆TF、TFPI含量。结果 :①SAP组血浆TF、TFPI水平及TF/TF PI比值均高于正常对照组 ,但差异无统计学意义 (P >0 .0 5 ) ,且治疗前后无明显变化 (P >0 .0 5 )。②UAP组、AMI组血浆TF、TFPI水平及TF/TFPI比值明显高于正常对照组 ,差异有统计学意义 (P <0 .0 1) ,但两组常规治疗前后差异无统计学意义 (P >0 .0 5 )。③AMI加维生素E组干预治疗后TF值显著下降 (P <0 .0 1) ,与正常对照组比较差异无统计学意义 (P >0 .0 5 ) ,TFPI干预治疗后无明显变化 (P >0 .0 5 ) ,而TF/TFPI比值明显降低 (P <0 .0 1)。④各组TF与TFPI呈明显正相关 (P<0 .0 5 ,r=0 .4 32 )。结论 :TF及TFPI在CHD尤其是急性冠状动脉综合征的发生中起重要作用 ,维生素E的干预显著降低患者血浆TF水平 ,降低TF/TFPI比值而对TFPI无影响。

Objective:The study was designed to discover the plasma levels of TF and TFPI in different type of coronary heart disease and to assess the efficacy of vitamine E in patients with acute myocardial infarction. Method: The plasma levels of TF and TFPI was assayed with ELISA method. The plasma concentration of TF and TFPI was measured in patients suffered from stable angina pectoris (SAP) group, unstable angina pectoris (UAP) group, acute myocardial infarction (AMI) group, and healthy subjects (control group). All patients were determined on immediate time and the second week after hospitalization. Result:①The plasma level of TF, TFPI and TF /TFPI ratio in SAP group was higher than that in control group, however the difference was not significant (P> 0.05). Also, the change was so little with treatment (P> 0.05).②The level of TF, TFPI and TF/TFPI ratio in UAP group and AMI group was much higher than that in control group significantly (P< 0.01). There was still no change with usual therapy (P>0.05). ③The level of TF in patients with AMI who were threated with vitamine E was decreased sharply on the second week (P< 0.01) and was not significantly different with control group (P> 0.05). The level of TFPI in the same patients didn't change respectively but TF/TFPI ratio was decreased significantly (P< 0.01) during treatment. ④TF concentration correlated positively to TFPI concentration (P< 0.05,r= 0.432). Conclusion:TF and TFPI are involved in the pathogenetic processes of coronary heart disease and play an important role in acute coronary syndrome. Vitamine E can decrease the level of TF, TF/TFPI ratio but not effect the level of TFPI.