冠状动脉粥样硬化性心脏病患者血浆可溶性细胞间黏附分子-1和可溶性血管细胞黏附分子-1水平检测

Determination of soluble intercellular adhesion molecule-1 and soluble vascular cellullar adhesion molecule-1 in patients with coronary heart disease

目的探讨不同临床表现的冠状动脉粥样硬化性心脏病(CHD)患者血浆可溶性细胞间黏附分子-1(sI-CAM-1)和可溶性血管细胞黏附分子-1(sVCAM-1)水平与冠状动脉粥样硬化病变严重程度的关系。方法74例CHD患者分为急性冠脉综合征(ACS)患者58例(包括急性心肌梗死20例(AMI组)和不稳定性心绞痛38例(UAP组))、稳定性心绞痛16例(SAP组)。另选取非冠心病患者15例(对照组)。采用酶联免疫吸附法(ELISA)测定上述各组外周血中sICAM-1和sVCAM-1的水平。采用Gensini积分系统评价病变血管的狭窄程度。结果62例行冠状动脉造影的CHD患者随Gensini积分的升高,sICAM-1与sVCAM-1水平有升高趋势(F分别为7.772与9.622,P均为0.000)。CHD患者sICAM-1和sVCAM-1水平均与冠状动脉粥样硬化病变Gensini积分呈正相关(r分别为0.415和0.487,P均<0.01)。AMI组和UAP组的sICAM-1水平((318.0±86.4)μg/L和(334.9±122.6)μg/L)高于SAP组((264.8±86.6)μg/L)和对照组((279.8±145.8)μg/L),P均<0.05。AMI组、UAP组和SAP组sV-CAM-1水平((407.8±182.1)μg/L、(446.3±160.4)μg/L、(386.5±104.2)μg/L)均明显高于对照组((307.7±23.2)μg/L),P均<0.05。结论sICAM-1和sVCAM-1水平可以反映冠状动脉粥样硬化病变的严重程度,前者升高能反映冠状动脉粥样斑块的不稳定状态。

Aim ： To explore the correlation between the level of adhesion molecule and the degree of stenosis of coronary artery. Methods： A total of 89 subjects were divided into 4 groups ： the patients with acute myocardial infarction （ AMI） group （ n = 20 ） , unstable angina pectoris （UAP） group （ n = 38 ） , stable angina pectoris （SAP） group （ n = 16 ） , and control group （ n = 15）. Plasma levels of sICAM-1 and sVCAM-1 were measured using enzyme-linked immunosorbent assay （ELISA）. The stenosis of coronary artery was evaluated with Gensini system. Results： The levels of sICAM-1 （r = 0. 415） and sVCAM-1 （r =0. 487） were positively correlated with the degree of coronary artery stenosis （P 〈0.01 ）. The levels of sICAM-1 in AMI group（ （318.0 ± 86.4） μg/L） and UAP group （ （334.9 ± 122.6） μg/L） were significantly higher than those in SAP group （ （264.8 ± 86.6） μg/L） and control group （ （ 279.8 ± 145.8） μg/L） （ P 〈 0.05 ）. The levels of sVCAM-1 in AMI group （ （407.8 ± 182.1 ） μg/L）, UAP group （ （446.3 ± 160.4） μg/L） and SAP group （ （386.5 ± 104.2） μg/L） were significantly higher than that in control group （ （307.7 ± 23, 2） μg/L） （P 〈0.05）. Conclusion： Plasma levels of sICAM-1 may reflect the severe degree of coronary heart disease, and the increase of sICAM-1 can reflect the unstable condition of plaque.