急性冠状动脉综合征患者P-选择素水平与冠状动脉病变的关系

The relationship between soluble P-selectin levels and the severity of coronary artery lesions in acute coronary syndrome

目的探讨急性冠状动脉综合征(ACS)患者可溶性P-选择素(sP-选择素)水平及其与冠状动脉病变的关系。方法应用酶联免疫吸附法检测54例ACS患者(ACS组)、15例稳定性心绞痛患者(SA组)和19例冠状动脉造影正常者(对照组)血浆sP-选择素水平,对冠状动脉粥样硬化病变程度按照病变支数、Gensini评分和美国心脏病学会和美国心脏病协会A、B、C型分型进行评估。结果ACS组sP-选择素水平高于SA组和对照组(P<0.01);sP-选择素水平与冠状动脉病变数量,Gensini评分,A、B、C型冠状动脉病变程度均为正相关。结论ACS患者P-选择素水平明显升高,提示P-选择素是ACS临床识别和预测的炎症指标;P-选择素水平受冠状动脉粥样硬化程度的影响。

Objective To investigate the relationship between soluble P-selectin levels and the severity of coronary ＇artery lesions in patients with acute coronary syndrome. Methods The plasma soluble P-selectin levels were measured by enzyme linked inlmunosorbent assay in 54 patients with acute coronary syndrome and 15 patients with stable angina peetoris and 19 normal persons without any angiographically detectable coronary ＂artery disease （control group）. The coronary artery lesion score was recorded according to single-, double- and tripie-vessel lesions, ACC/AHA proposed type A, B and C lesion and Gensini scoring system. Results The level of plasma soluble P- selectin was significantly higher in the acute coronary syndrome group [ （191.4 ±63.7） ng/L] than in the control group [（ 145.3 ± 21.7） ng/L, P 〈 0.01 ] and in the stable angina pectoris group [ （141.3 ± 17.9） ng/L, P 〈 0.01 ]. The level of plasma soluble P- selectin was positively correlated with the Gensini score（ r = 0.391, P = 0.001）, the number of vessels with lesions（ r = 0. 349, P = 0.003） and type A, B and C lesions（ r = 0. 358, P = 0. 002）. Conclusions The elevated soluble P- selectin level in acute coronary syndrome suggested the possible relation of P- selectin to the pathogenesis of acute coronary syndrome, which may serve as a potential marker of plaque instability. The positive correlation between the level of soluble P- selectin and the coronary artery score may indicate that soluble P- selectin levels might reflect the severity of coronary heart disease.