血浆甲壳质酶蛋白40和内皮微粒与老年急性冠状动脉综合征的相关性研究

Correlation of plasma enzyme chitin 40 and endothelial microparticle with acute coronary syndrome in elder patients

目的:探讨血浆甲壳质酶蛋白40(YKL-40)和内皮微粒(EMP)与老年急性冠状动脉综合征(ACS)之间的相关性。方法:选择行冠状动脉造影检查且年龄≥65岁者180例,随机分为ACS组(n=96)和对照组(n=84)。应用酶联免疫吸附法检测血浆YKL-40水平;应用流式微球技术检测血浆EMP水平,以CD31^+/CD42b-EMPs为标志;采用Gensini评分对每支血管病变狭窄程度进行定量计算。结果:ACS组血浆YKL-40和CD31^+/CD42b-EMPs水平均明显高于对照组(P<0.01)。ACS组患者Gensini评分值与血浆YKL-40和CD31^+/CD42b-EMPs水平均呈正相关关系(r=0.522,P<0.01;r=0.561,P<0.01)。ACS组患者血浆YKL-40水平和CD31^+/CD42b-EMPs水平呈正相关关系(r=0.625,P<0.01)。结论:老年ACS患者血浆YKL-40和EMP水平明显升高,且升高水平与冠脉病变程度有关,提示两者有可能成为诊断ACS的一个新的生化标志物,并为冠状动脉病变程度及危险分层提供参考依据。

Objective：To investigate the correlation of the levels of plasma enzyme chitin 40（YKL-40） and endothelial microparticle （EMP） with the acute coronary syndrome（ACS） in elder patients. Methods：A total of 180 patients（≥65 years old） with coronary angiography were randomly divided into the ACS group（96 cases） and control group（84 cases）. The serum levels of plasma YKL-40 and EMP in two groups were measured by Enzyme-linked immunosorbent assays and cytometric bead assay technique labeled by CD31^＋/CD42b^-EMPs,respectively. The vascular stenosis degree was quantified by Gensini score. Results：The levels of the YKL-40 and CD31^＋/CD42b^-EMPs in ACS group were significantly higher than those in control group（P 〈0. 01）. The Gensini score was significantly positive correlation with the levels of YKL-40 and CD31^＋/CD42b^-EMPs in ACS group（r=0. 522,P〈0. 01;r=0. 561,P〈0. 01）. The level of YKL-40 was significantly positive correlation with the level of CD31^＋/CD42b^-EMPs in ACS group（r=0. 625, P〈0. 01）. Conclusions：The levels of plasma YKL-40 and CD31^＋/CD42b^-EMPs in ACS patients increase significantly,which is related to the vascular lesion degree. The YKL-40 and EMP maybe a new biochemical marker in diagnosing ACS,which can provide a reference in identifying the severity and risk stratification of coronary artery lesions.