急性冠状动脉综合征患者外周血CD31^(bright)/Annexin V^+内皮微粒水平增高

Increased Circulating CD31^(bright)/Annexin V^+ Endothelial Microparticles in Patients with Acute Coronary Syndromes

目的观察急性冠状动脉综合征患者与非冠心病患者外周血内皮微粒水平,探讨CD31bright/Annexin V+内皮微粒与心血管危险因素的相关性。方法急性冠状动脉综合征患者56例,非冠心病患者26例,采用流式细胞仪检测外周血CD31bright/Annexin V+内皮微粒水平。结果与非冠心病患者比较,急性冠状动脉综合征患者外周血CD31bright/Annexin V+内皮微粒显著增加(P<0.01),而急性心肌梗死与不稳定型心绞痛亚组之间外周血CD31bright/Annexin V+内皮微粒水平无显著性差异(P>0.05)。所有入选患者中,2型糖尿病患者外周血CD31bright/Annexin V+内皮微粒水平较非糖尿病患者显著升高(P<0.05);多因素回归分析显示,血清甘油三酯水平与外周血CD31bright/Annexin V+内皮微粒数量独立正相关(r=0.28,P<0.05)。急性冠状动脉综合征组血清高敏C反应蛋白水平与外周血CD31bright/Annexin V+内皮微粒数量呈正相关(r=0.31,P<0.05)。结论急性冠状动脉综合征患者和糖尿病患者外周血CD31bright/Annexin V+内皮微粒增多,提示急性冠状动脉综合征患者和2型糖尿病患者内皮损伤严重。CD31bright/Annexin V+内皮微粒水平增高可能与血清甘油三酯和血清高敏C反应蛋白水平增高有关。

Aim To investigate circulating levels of endothelial microparticle （ EMP） in the plasma of patients with acute coronary syndromes （ACS） , and to explore correlations between circulating EMP count and conventional risk factors of cardiovascular disease （ CVD ）. Methods A case-controlled study was conducted in 56 patients with ACS and 26 control subjects without coronary heart disease. Circulating levels of CD31 ^bright/Annexin V ^＋ EMP were measured by flow cytometric analysis. Results Plasma CD31^bright /Annexin V^＋ EMP levels were significantly higher in patients bright with ACS than those in control subjects （ P 〈 0.01 ）. However there was no significant difference m plasma CD31^bright /A^＋ nexin V ^＋ EMP counts between patients with AMI and those with UAP. Among all subjects, patients with type 2 diabetics had increased plasma CD31 ^bright/Annexin V ^＋ EMP as compared with patients without diabetics （ P 〈 0.05 ）. On multivariate analysis, serum triglyeeride level was the major independent factor related to plasma CD31^bright/Annexin V^＋ EMP count （ r = 0.28, P 〈 0. 05 ）. In patients with ACS, linear regression analysis showed a strong positive correlation between serum high sensitivity C-reactive protein level and plasma CD31^ bright/Annexin V ^＋ EMP count （ r = 0. 31, P 〈 0.05 ）. Conclusions Plasma CD31^bright/Annexin V^＋ EMP increased in patients with ACS or diabetics, and plasma CD31^bright/Annexin V^ ＋ EMP count was correlated with conventional risk factors for CVD. These findings suggest that the more critical endothelial damage is present in ACS patients and type 2 diabetics patients, increased level of plasma CD31^bright/Annexin V^＋ EMP is relative with high concentration of plasma hs-CRP and triglyceride.