急性冠脉综合征患者组织因子、组织因子途径抑制物、肿瘤坏死因子-α的变化及其相关性

Alteration and Correlation of Tissue Factor,Tissue Factor Passway Inhibitor and Tumor Necrosis Factor-α Alteration in Patients with Acute Coronary Syndrome

目的观察急性冠脉综合征(ACS)患者组织因子(TF)、组织因子途径抑制物(TFPI)、肿瘤坏死因子-α(TNF-α)水平与TF活性的变化,分析它们之间的相关性,探讨凝血与炎症在冠心病病程中的临床意义。方法选择ACS组患者36例,稳定性心绞痛(SAP)组患者32例,正常对照组28例,采用酶联免疫双抗体夹心法(ELISA法)测定血浆TF、TFPI水平,放射免疫分析法测定血清TNF-α水平,采用发色底物法测定TF活性。结果ACS组TF、TFPI、TNF-α水平及TF活性均显著高于SAP组与正常对照组(P<0.01),SAP组TF、TFPI水平与TF活性也显著高于正常对照组(P<0.01),但TNF-α在两组之间无显著性差异(P>0.05),ACS组患者血浆TF活性与血浆TFPI水平显著正相关(γ=0.524,P<0.01),血浆TF活性与血清TNF-α水平显著正相关(γ=0.462,P<0.01)。结论TF、TFPI、TNF-α水平及TF活性在ACS中可作为反映凝血异常和炎症状态的指标之一。

Objective To observe the changes and correlation of tissue factor （TF）, tissue factor passway inhibitor （TFPI） and tumor necrosis factor α （TNF- α）, and to explore their clinical significance in patients with coronary heart disease （CHD）. Methods The levels of TF, TFPI ,TNF- α and TF activity were measured in 68 patients with acute coronary syndrome （ACS） （n= 36） and stable angina pectoris （SAP） （n= 32）, and 28 healthy controls. Results In patients with AOS, levels of TF, TFPI, TNF - α and TF activity were sigfiificantly higher than those in SAP and control groups （P〈0.01）. In patients with SAP, levels of TF, TFPI and TF activity were significantly higher than those in control group （P〈 0.01）, but TNF α showed no significant difference between the two groups （P 〉 0.05）. Linear correlation analysis revealed that TF activity was positively correlated with TFPI and TNF- α （ γ=0.524, P〈0.01 ; γ=0.462, P〈0.01）. Conclusion These thrombotic and inflammatory indexes might be used as the important indicators in diagnosis of AOS.