血浆蛋白Z与颈动脉内膜中层厚度在急性冠脉综合征中的临床意义

The clinical significance of plasma protein Z and carotid artery intimamedia thickness in patients with acute coronary syndrome

目的研究在急性冠脉综合征(ACS)中血浆蛋白Z(PZ)与颈动脉内膜中层厚度(IMT)的临床意义及其相关性。方法筛选60例急性冠脉综合征患者(按照Gensini积分分为A、B、C三组),15例正常对照组受试者。采取静脉血以ELISA方法检查PZ浓度,彩色B超进行颈动脉IMT检查。结果与对照组相比,ACS组PZ显著下降(P<0.05),颈动脉IMT上升(P<0.05)。在ACS组内,随着Gensini评分增高,PZ水平随Gensini积分的上升而下降,且组内间每两级之间均有显著性差异(P<0.05);而颈动脉IMT则增加,组内每两级之间均有显著性差异(P<0.05)。结论 ACS的严重度可能与PZ水平与呈负相关,而与颈动脉IMT呈正相关,表示PZ水平下降可能是ACS的一个独立危险因素,IMT厚度增加可能加重ACS斑块的不稳定性,检测其水平可能有助于评估急性冠脉综合征的严重度。

Objective To study the clinical significance and correlation of plasma protein Z and carotid artery intimamedia thickness in patients with acute coronary syndrome. Methods Sixty acute coronary syndrome patients（according to the Gensini score were divided into A、B、C group）, and 15 normal control subjects were recruited for this study. PZ levels were measured by enzyme linked immunosorbent assay, carotid IMTs were measured by B ultrasound measure ment. Results Compared with the control group, PZ levels of ACS group significantly decreased（P〈0.05）,carotid artery IMTs significantly increased（P〈0.05）. In the ACS group, with the score of Gensini increased,PZ level decreased with the rising of Gensini score,and there were significant differences between each two groups（P〈0.05）;Carotid artery IMT increased with the rising of Gensini score,and there were significant differences between each two groups（P〈0.05）. Conclusion The ACS severity is negatively correlated with PZ level, but positively correlated with carotid IMT,which shown that the reduction of PZ levels may be an independent risk factor of ACS, increased IMT may in crease ACS plaque instability. Combined detection of PZ and carotid artery IMT may have an important valve in severity of the acute coronary syndrome.