冠心病患者ET-1水平变化及与预后关系的分析

The analysis of the relationship between Endothelin-1 and the prognosis of coronary heart disease

目的探讨冠心病患者血清内皮素-1(ET-1)水平变化及与预后的关系。方法随机选取2005年7月至2006年11月在南华大学附属第二医院住院确诊的冠心病(CHD)患者120例(试验组)及健康体检者31名(对照组)。CHD患者中,稳定型心绞痛(SAP)、不稳定型心绞痛(UAP)、ST段抬高型心肌梗死(STEMI)和非ST段抬高型心肌梗死(NSTEMI)各30例。所有入选对象于入院后24h内采血样本,健康体检者于体检当时采血样本,分离、冷藏血清,用ELISA方法测定ET-1浓度。随访研究对象,了解CHD患者近期急性心血管事件发生率。结果①STEMI组、NSTEMI组、UAP组和SAP组血清ET-1水平分别为(28.67±4.09)ng/L、(16.69±1.68)ng/L、(14.33±2.39)ng/L、(6.04±1.01)ng/L,均较正常对照组血清ET-1水平(3.35±1.02)ng/L显著升高(P<0.01);STEMI组分别与NSTEMI组、UAP组、SAP组比较血清ET-1水平,SAP组分别与NSTEMI组、UAP组比较血清ET-1水平,差异均有统计学意义(P<0.01),但是,UAP组和NSTEMI两组组间比较血清ET-1水平差异无统计学意义(P>0.05)。②实验对象血清ET-1高水平组(22.53%)较低水平组(8.66%)近期心血管急性事件发生率增高。结论血清ET-1水平高低可反映冠心病患者病情严重性和近期急性心血管事件发生的可能性。

Objective To investigate the relation between endothelin-1 and the prognosis of coronary heart disease, we tested the serum concentration of endothelin-1 in them and observed the prognosis of them. Methods One hundred and twenty patients were selected at random during over the year, and were divided into four groups, including SA（n=30）, UA（n=30）, STEMI（n=30）, NSTEMI（n=30）.Besides, there were 31 healthy people as normal contrast group.All cases were, within 24 hours, tested the serum concentration of ET-1 by ELISA. At the same time, they were checked by coronary arteriography.To observed the rate of cardiovascular events, we followed up all CHD cases in the near future. The results were analyzed with the statistics software of SPSS 13.0. Results （1）The difference of serum concentration of ET-1 in STEMI （28.67± 4.09）ng/L,NSTEMI （16.69±1.68）ng/L, UAP（ 14.33±2.39）ng/L and SAP（6.04±1.01 ）ng/L was significantly high as compared with the control group （3.35±1.02）ng/L, （P〈0.01）,moreover,the serum concentration of ET-1 was significantly higher in STEMI than in NSTEMI,UAP,SAP （P〈0.01）, and higher in NSTEMI, UAP respectively than in SAP（P〈0.01 ）, but the concentration of ET-1 between the UAP and NSTEMI was slight （P〉0.05）. （2）The incidence rate of the acute cardiovascular disease in the near future was growing with the increase of the level of serum concentration of ET-1 （P〈0.01）. Conclusion The serum concentration of ET-1 couht reflect the serious degree of coronary heart disease and the danger of the acute cardiovascular events in a short term in ACS patients.