急性冠脉综合征患者外周血细胞黏附分子水平变化及其临床意义

Change and implication of adhesion molecules in peripheral blood of patients with acute coronary syndrome

目的:探讨细胞黏附分子与急性冠脉综合征患者病变程度及临床意义。方法:酶联免疫吸附法测定32例急性冠脉综合征患者,24例稳定型心绞痛患者,20例健康人血清血管间细胞黏附分子_1(vascular celladhesion molecules,VCAM_1),细胞间黏附分子_1(inter cellular adhesion molecules,ICAM_1),肿瘤坏死因子(tumornecrosis factor_α,TNF_α)水平变化,分析冠状动脉病变情况。结果:血清VCAM_1,ICAM_1,TNF_α在急性冠脉综合征组高于稳定型心绞痛组及对照组;急性冠脉综合征组和稳定型心绞痛组冠状动脉狭窄程度积分与外周血VCAM_1I、CAM_1及TNF_α水平无相关性;急性冠脉综合征组外周血VCAM_1,ICAM_1与TNF_α水平呈正相关。结论:VCAM_1,ICAM_1与急性冠脉综合征的严重程度有关,但与冠状动脉狭窄程度无明显关系;VCAM、ICAM_1与TNF_α成正相关提示它们之间相互作用共同促进冠状动脉粥样硬化进展。

To explore the correlation and its significance of adhesionmolecules in the peripheral blood of patients with acute coronary syndrome （ ACS）. Methods ： Adhesion molecules and tumor necrosis factor-α（TNF-α） were measured in thirty-two patients with ACS group,twenty-two patients with stable angina pectoris （SAP group） and twenty patients with control subjects （control group） by enzymelinked immune absorption assay （ELISA）,and coronary artery lesions were analyzed. Results： ①Adhesion molecules level and TNF-α level were significantly higher in patients with ACS than in those of stable angina pectoris （SAP） and control group.② The level of adhesion molecules in peripheral blood was not correlated with culprit coronary artery lesion in ACS and SAP groups. ③ Adhesion molecules level was positively correlated with TNF-α level in ACS. Conclusion ： The levels of adhesion molecules and TNF-α can evaluate the severity of coronary heart disease, but the level of adhesion molecules has no correlation with the degree of coronary lesions in ACS and SAP group. There are correlation between the levels of adhesion molecules and TNF-α, which maybe implicates that the interaction of inflammatory factors may facilitate the development of ACS.