冠状动脉粥样硬化性心脏病患者外周血CD31^(bright)/AnnexinV^+内皮微粒水平增高

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

目的观察冠状动脉粥样硬化性心脏病(冠心病)患者与非冠心病患者外周血内皮微粒水平,探讨内皮微粒与冠心病及其危险因素的相关性。方法入选研究对象102例,分为对照组非冠心病患者(n=30),稳定型心绞痛(SAP)组(n=16),不稳定型心绞痛(UAP)组(n=24),急性心肌梗死(AMI)组(n=32)。全部病例均经冠状动脉造影证实冠状动脉病变情况。采用流式细胞仪检测外周血CD31bright/AnnexinV+内皮微粒水平。结果与对照组非冠心病患者外周血内皮微粒[(1628.4±623.7)/mL]比较,冠心病患者外周血内皮微粒[(2850.7±710.6)/mL]显著增加(P<0.01),而急性心肌梗死(AMI)与UAP及SAP亚组之间外周血内皮微粒水平无显著差异(P>0.05)。冠心病组及对照组所有入选患者中,2型糖尿病患者外周血内皮微粒水平较非糖尿病患者显著升高(P<0.05);多元线性回归分析显示血清三酰甘油水平与外周血内皮微粒数量呈正相关(r=0.32,P<0.05)。结论冠心病患者和2型糖尿病患者外周血内皮微粒增多,提示冠心病患者和2型糖尿病患者内皮损伤严重。

Objective To investigate the circulating levels of endothelial microparticles （EMPs） in the plasma of patients with coronary atherosclerotic heart disease （CHD）,and to explore the correlations between circulating EMPs count and conventional risk factors of CHD.Methods A case-controlled study was conducted in 72 patients with CHD and 30 controls without CHD.Included were 32 patients with acute myocardial infarction （AMI）,24 unstable angina pectoris （UAP） and 16 stable angina pectoris （SAP）.All patients were confirmed by coronary angiography （CAG）.Circulating levels of CD31^bright/AnnexinV^＋ EMPs were measured by flow cytometric analysis.Results The levels of plasma EMPs were significantly higher in patients with CHD [（2850.7±710.6）/mL] than those in control subjects [（1628.4±623.7）/mL] （P〈0.01）.However,there was no significant difference in plasma EMPs counts between patients with AMI and those with UAP or SAP.Among all subjects,patients with type 2 diabetics had increased plasma EMPs compared to patients without diabetics （P〈0.05）.Multivariate analysis showed a strong positive correlation between serum triglyceride level and plasma EMPs count （r=0.32,P〈0.05）.Conclusion Plasma EMPs increased in patients with CHD or type 2 diabetes; plasma EMPs count was correlated with conventional risk factors for CHD.These findings suggest that a severer endothelial damage is present in CHD patients and patients with type 2 diabetes; increased level of plasma EMPs is related to high concentration of plasma triglyceride.