ANGPTL2表达与急性冠脉综合征患者的关联性及其意义

Association and significance of ANGPTL2 and patients with acute coronary syndrome

目的探讨血管生成素样蛋白(angiopoietinlike protein,ANGPTL)2表达与急性冠脉综合征(ACS)患者的关联性及其意义。方法冠心病患者121例分为2组:ACS组〔88例,其中ST段抬高型急性心肌梗死(STEMI)48例,非ST段抬高型急性冠脉综合征(NSTE-ACS)40例〕和稳定型心绞痛(SAP)组(33例)。收集外周血血浆,采用酶联免疫吸附试验检测ANGPTL2的浓度;抽吸获得STEMI患者的冠脉血栓,免疫组化SABC法检测ANGPTL2在冠脉血栓中的表达情况。结果 ANGPTL2血浆浓度在ACS组显著高于SAP组(P<0.01),并且在STEMI组也显著高于NSTE-ACS组(P<0.01)。多因素回归分析显示,ANGPTL2为ACS的独立相关因素(OR=3.15,95%CI,1.64-6.02,P<0.01)。ANGPTL2在STEMI患者的冠脉血栓中高表达。结论 ANGPTL2在ACS患者中高表达是ACS患者的独立相关因素,也可能与血小板成栓有密切关系。

AIM To investigate the significance and association of angiopoietin-like protein 2 （ANGPTL2） in acute coronary syndrome （ACS） patients. METHODS One hundred and twenty-one subjects were recruited and were divided into ACS group [ n = 88 patients, including 48 patients with ST-segment eleva- tion myocardial infarction （STEMI） and 40 patients with non-ST elevation acute coronary syndrome （NSTE-ACS） ] and stable angina pectoris （SAP） group （n = 33 ）. Peripheral blood plasma was collected and enzyme-linked immunosorbent assay was used to test the concentration of ANGPTL2. Aspiration was used to obtain coronary thrombus in STEMI patients and ANGPTL2 expression was detected by SABC immunohistochemieal method. RESULTS Plasma ANGPTL2 levels in ACS patients were significantly higher than in SAP patients （ P 〈 0.01 ）. Plasma ANGPTL2 levels in patients with STEMI were signifi- candy higher than those in patients with NSTE-ACS （ P 〈 0. 01 ）. Multivariate analysis showed that ANGPTL2 was an independent risk factor of ACS. In addition, ANGPTL2 was highly expressed in coronary thrombus. CONCLUSION High expression of ANGPTL2 in ACS patients is an independently associated factor and may have a close relationship with platelet thrombus.