脂代谢紊乱、超敏C反应蛋白和血管性假性血友病因子与冠状动脉病变相关性研究

Ralation of lipoprotein,high sensitive C-reactive protein and von Willebrand factor to coronary heart disease

目的:观察脂代谢指标、超敏C反应蛋白(hs-CRP)和血管性假性血友病因子(vWF)与冠状动脉病变的关系及其相关性。方法:经冠状动脉造影证实的急性冠脉综合征(ACS)患者74例,其中急性心肌梗死(AM I)32例,不稳定性心绞痛(UAP)42例,另选23例冠状动脉造影阴性者为对照组,测定其血清总胆固醇(TCHO)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(apoA1)、载脂蛋白B(apoB)、hs-CRP和血浆vWF水平。结果:AM I组和UAP组HDL-C和apoA1明显低于对照组、hs-CRP和vWF明显高于对照组。三支血管病变组hs-CRP和vWF明显高于单双支病变组,hs-CRP和vWF与血管病变支数呈正相关。结论:急性冠脉综合征患者HDL-C和apoA1降低、hs-CRP和vWF升高,且hs-CRP和vWF与ACS严重程度相关,可能是ACS发生的危险因素。

Objective：This study is to evaluate the serum lipoprotein, high -sensitivity C -reactive protein （hs -CRP） and yon Willebrand factor（vWF） which is used to predict the clinical severity in patients with acute coronary syndrome（ACS）. Methods： total cholesterol （TCHO）,triglyceride （TG）, high density lipoprotein- cholesterol （HDL- C ）, low density lipoprotein- cholesterol （LDL- C） ,apolipoprotein （apoAl） ,apolipoprotein （apoB）, hs - CRP and vWF were measured in patients. Combined with coronary angiography, the clinical severity was assessed. Results： HDL - C and apoA1 were all significantly lower in AMI and UAP group, hs - CRP and vWF were all significantly higher in AMI and UAP group compared with control group,but there was no significant difference between AMI and UAP group, hs - CRP and vWF were in direct proportion to the number of injured coronary in patient with ACS. Conclusions： The present study indicates that serum HDL - C, vWF and hs - CRP may be a risk factor of coronary artery disease, vWF and hs - CRP can reflect the clinical severity, and may mark unstable atherosclerotic plaque in patients with coronary heart disease.