冠心病患者血浆P-选择素、血管性假性血友病因子水平变化及临床意义

Changes and clinical significance of P-selectin and von Willebrand factor in patients with coronary heart disease

目的观察冠心病患者血浆P-选择素、血管性假性血友病因子(vWF)浓度的改变并探讨其临床意义。方法分别测定28例稳定型心绞痛(SA)患者、39例不稳定型心绞痛(UA)患者、21例正常对照组体内的P-选择素、vWF含量,并分析有无冠状动脉事件发生者与P-选择素、vWF之间的关系,同时探讨P-选择素与vWF的相关关系。结果UA组P-选择素、vWF含量明显高于SA组,(13.11±4.13)μg/L vs(10.92±3.16)μg/L,(159.1±45.4)%vs(136.3±43.8)%(均P<0.05)和对照组(10.21±3.38)μg/L,(124.5±36.9)%(均P<0.05),而SA组与对照组比较差异无统计学意义(P>0.05);有冠状动脉事件发生者与无冠状动脉事件发生者比较,P-选择素(13.59±4.24)μg/L vs(11.23±3.67)μg/L和vWF(167.9±38.7)%vs(140.0±49.4)%差异均有统计学意义(P<0.05);UA患者P-选择素水平与vWF水平成正相关(r=0.331,P<0.05),有冠状动脉事件发生者二者亦呈正相关(r=0.397,P<0.05)。结论血浆P-选择素、vWF水平可作为冠状动脉血栓形成的指标之一,并在一定程度上反映了冠状动脉事件发生的危险性。

Objective To compare plasma P-seleetin and yon Willebrand faetor（vWF） concentrations in patients with coronary heart disease. Methods P-selectin and vWF in 28 patients with stable angina（SA group）, 39 patients with unstable angina（UA group） ,and 21 controls（control group） were measured. The changes of P-selectin and vWF in patients with and without coronary events were compared. The correlation between P-seleetin and vWF was also analyzed. Results There were significant differences of P-selectin and vWF between UA group and SA group, （13.11 ±4.13）μg/L vs （10.92±3.16） μg/L, （159.1±45.4）% vs （136.3± 43.8）% （both P 〈0.05） or control group, （10.21± 3.38）, （124.5±36.9）% （both P 〈0.05）, while there was no significant difference between SA group and control group（ P 〉0.05）. There were also significant differences of P-seleetin and vWF between patients with coronary events and patients without coronary events, （13.59±4.24） μg/L vs （11.23± 3.67） μg/L, （167.9 ± 38.7） % vs （140.0±49.4） % （ P 〈0.05）. There was a positive correlation between P-selectin and vWF level in SA group （r = 0. 331, P 〈0.05）, patients with coronary events（ r = 0. 397, P 〈0.05）. Conclusion P-seleetin and vWF may be regarded as the indexes of coronary thrombosis and used for predicting the severity of coronary events.