冠心病病人血清OXLDL与sICAM-1变化及其意义

THE CHANGES AND THE CLINICAL SIGNIFICANCE OF OXIDATIVE LOW DENSITY LIPOPROTEIN AND SOLUBLE INTERCELLULAR ADHESION MOLECULE 1 IN PATIENTS WITH CORONARY HEART DISEASE

目的探讨冠心病(CHD)病人血清氧化低密度脂蛋白(OXLDL)和可溶性细胞间黏附分子-1(sICAM-1)的变化及其意义。方法采用酶联免疫吸附法,测定20例急性心肌梗死(AMI)病人、20例不稳定型心绞痛(UAP)病人、20例稳定型心绞痛(SAP)病人血清OXLDL、sICAM-1水平的变化,并与20例正常对照组进行比较。结果AMI病人血清OXLDL、sICAM-1水平均高于UAP病人、SAP病人和对照组(F=37.85、27.37,q=6.14～14.09,P<0.01);UAP病人血清OXLDL、sICAM-1水平显著高于SAP病人和对照组(q=4.74～7.67,P<0.01);SAP病人血清OXLDL与sICAM-1水平与对照组之间亦有显著差异(q=2.93、2.90,P<0.05)。不同类型冠心病病人血清OXLDL、sICAM-1水平分别呈显著正相关(r=0.770～0.862,P<0.01)。血清OXLDL、sICAM-1水平在AMI、UAP组ROC曲线下的面积均大于0.90,血清OXLDL、sICAM-1对AMI病人诊断灵敏度和特异度分别为0.90、0.90和0.90、0.95,对UAP病人诊断的灵敏度和特异度分别为0.85、0.90和0.80、0.85。结论血清OXLDL、sICAM-1浓度的变化对AMI和UAP具有明显的诊断价值和较高的诊断准确度,且两者呈显著正相关,其升高的程度可以作为炎症反应增强和病情严重的判断指标之一。

Objective To explore the changes and clinical significance of serum oxidative low density lipoprotein （OXLDL） and soluble intercellular adhesion molecule-1 （sICAM-1） levels in patients with coronary heart disease （CHD）. Methods By using enzyme-linked immunosorbent assay （ELISA）, OXLDL and sICAM-1 were measured in patients with acute myocardial infarction （AMI）, with unstable angina pectoris （UAP） and with stable angina pectoris （SAP）, 20 patients in each group and 20 controls. Results The serum levels of OXLDL, sICAM-1 in AMI patients were much higher than that of UAP, SAP and the controls （F=37. 85,27.37;q=6. 14--14. 09;P〈0. 01）, the levels of OXLDL and sICAM-1 were much higher in UAP than that of SAP and the controls （q=4.74-7.67,P〈0.01）, the difference of levels of OXLDL and sICAM-1 between SAP and the controls was significant （q=2. 93,2.90;P〈0. 05）. The levels of OXLDL and sICAM-1 revealed a positive correlation between differenttype CHD （r=0. 770-0. 862,P〈0.01）. The areas of levels of OXLDL and sICAM-1 under the ROC curve （AUC^ROC） were all greater than 0.9 with the sensitivity and specificity of 0.90, 0.90 and 0.90, 0.95 in AMI, and 0.85, 0.90 and 0.80, 0.85 in UAP, respectively. Conclusion The changes of OXLDL and sICAM-1 possess a great value and higher accuracy in the diagnosis of AMI and UAP and both parameters were positively correlated. The rising degree of OXLDL and sICAM-1 may be used as one of the indexes for estimating the severity of inflammation and of the disease.