P-选择素、同型半胱氨酸与冠心病的相关性研究

Correlations between the Soluble P-Selectin,High Sensitive C-Reactive Protein and Homocysteine with Coronary Heart Diseases

目的①观察冠心病患者血清可溶性P-选择素、高敏C-反应蛋白及同型半胱氨酸水平,研究三者能否预测冠心病的严重程度。②通过实验研究冠心病患者可溶性P-选择素、高敏C-反应蛋白和同型半胱氨酸水平三者的相关性,探讨血小板功能与内皮细胞功能及血管炎症反应间的关系。方法本研究选取急性心肌梗死患者(AMI组)21例,不稳定型心绞痛患者(UAP组)25例,稳定型心绞痛患者(SAP组)20例和冠脉造影排除冠心病者(对照组)20例。用ELISA法测定其血清可溶性P-选择素、hs-CRP和同型半胱氨酸水平。结果①P-选择素、hs-CRP、Hcy水平分别在AMI组、UAP组和SAP组,两两比较差异有统计学意义(P均<0.05),而SAP组和对照组比较差异无统计学意义(P>0.05)。②冠心病患者P-选择素与hs-CRP相关系数r=0.456(P<0.05),Hcy与hs-CRP相关系数r=0.210(P<0.05),P-选择素与Hcy相关系数r=0.848(P<0.05)。结论①P-选择素、hs-CRP和Hcy水平在AMI组和UAP组较SAP组和对照组明显升高,其中AMI组最高,其次为UAP组,再次为SAP组。②血清Hcy水平,Hs-CRP水平及P-选择素水平具有良好的正相关性,均随病情的严重程度的加重而升高。联合检测三者可协助了解病情,为指导治疗及判断预后提供依据。

Objective ①To study the value of levels of the serum soluble P-selectin （ sP-selectin）, high sensitivity C-reactive protein （hs-CRP） and FIomocysteine （Hcy） in predicting the severity of CHD. ②To study the correlation among the serum sP-selectin, Hcy and hs-CRP in patients with CHD, and explore the relationship between the platelet function and endotheliocyte function and vascular inflammatory reaction. Methods The levels of sP-selectin, hs-CRP, HCY were measured by ELISA in 21 patients with acute myocardial infarction（ group AMI） ,25 patients with unstable angina pectoris（ group UAP） ,20 patients with stable angina peetoris （ group SAP）, and 20 controls. Results ① The levels of sP-selectin, hs-CRP and Hcy in group AMI （274.81 ±5.24） μg/L and group UAP（200.44 ± 8.47） ng/L were significantly higher than that in group SAP（ 103.87 ＋ 9.59） ~xg/L and the controls（ 101.16 -. 9.67） txg/L;the concentration of sP-selectin was similar in group SAP（ 103.87 ±9.59） I^g/＇L and the controls（ 101.16 ± 9.67 ） i^g/L. ~）There were obvious positive correlations between the concentration of sP-selectin and hs-CRP（ r = 0.456, P 〈 0.05 ）, the concentration of sP-selectin and HCY （ r = 0.848, P 〈 0.05 ）, and between the hs-CRP and HCY（r = 0.210 ,P 〈 0.05）. Conclusion ①ACS patients have higher level of P-selectin, hs-CRP and HCY than as compared to the SAP patients. ②sP-selectin is positively associated with Hs-CRP and Hcy. It is helpful to diagnosis, therapy and prognosis of CHD by detecting Hcy, sP-selectin and Hs-CRP.