可溶性细胞间黏附分子-1与不稳定型心绞痛病人预后的关系

Relationship between level of peripheral blood sICAM-1 and prognosis of unstable angina patients

目的探讨不稳定型心绞痛(unstable angina pectoris,UA)病人外周血可溶性细胞间黏附分子(soluble intercellular adhesion molecule-1,sICAM-1)水平及其与预后的关系。方法UA组86例,稳定型心绞痛(stable angina pectoris,SAP)组22例。对照组20名为体检健康者。入院24h内或接受体检时采集血标本。用酶联免疫吸附试验方法测定外周血sICAM-1水平。对比较UA组病人心肌梗死试验性溶栓疗法危险评分与sICAM-1水平关系。随访30d和90d,统计心血管不良事件。结果UA病人外周血sICAM-1水平显著高于SAP病人(P<0.01);UA病人sICAM-1水平随心肌梗死试验性溶栓疗法危险积分的增高而增高;高sICAM-1组的不稳定型心绞痛病人近期心脏不良事件发生率明显升高(P<0.01)。结论外周血sICAM-1水平可反映UA病情危险程度,UA病人近期心血管不良事件与高外周血sICAM-1水平有关。

Objectives To explore the clinical value of peripheral blood intercellular adhesion molecule-1 （sICAM-1） in prognosis evaluation and dangerous classification of unstable angina patients （UAP）. Methods 108 cases were chosen as study groups according to patient history, clinical symptoms, creatinase, ECG and coronary angiography （CAG）, and 20 healthy persons as normal control group. After blood samples of patients were collected in 24 hours after admission, the peripheral blood levels of sICAM-1 were measured through enzyme-linked immunosorbent assay （ELISA）. The serum levels of sICAM-1 were compared between the different groups divided by calculating the risk scores of thrombolysis in myocardial infarction trial （TIMI）. All UAP patients followed up during 30 days and 90 days, cardiac events were recorded. The incidence of them were compared among different groups. All results were analyzed with SPSS 13.0. Results ①There were significant differences in peripheral blood levels of sICAM-1 among the three groups, UA group was higher than SA group, SA group higher than control group （P〈0.01）. ②The peripheral blood levels of sICAM-1 was significantly positive correlation with the risk scores of TIMI. ③The incidence of cardiac events in UA patients were increased when the levels of sICAM-1 were high （P〈0.01）. Conclusions ①The peripheral blood levels of sICAM-1 in UA patients can reflect the conditions of UA patients. ②The levels of sICAM-1 can predict prognosis of patients with UA in a short period.