单核细胞组织因子的动态检测在老年急性冠状动脉综合征诊疗中的意义

Dynamic study of mononuclear cell TF in elderly patients with acute coronary syndrome

目的同步观察单核细胞（Mo）组织因子（TF）及血浆TF水平在老年急性冠状动脉综合征（ACS）患者急性期及恢复期中的动态变化。方法选择ACS患者97例，其中包括急性心肌梗死（AMI）组52例，不稳定型心绞痛（UA）组45例及正常对照组50例。采用RT—PCR法对所有纳入对象进行MoTFmRNA检测，并采用ELISA法同步检测血浆组织因子抗原（TFAg）。结果与对照组比较，AMI及uA组患者急性期MoTFmRNA（0．258±0．070，0．304±0．083及0．291±0．040）和血浆TFAg（192．89±91．36，263．14±114．98及258．73±110．12）均明显增高（P〈0．05）；MoTF mRNA表达与TFAg水平明显正相关（P〈0．05）。恢复期MoTFmRNA在AMI、uA组虽均呈下降趋势（0．284±0．048及0．279±0．039），但与对照组比较仍明显增高（P〈0．05）；而血浆TFAg在AMI及UA组（212．84±101．36及218．74±99．82）呈同步下降，与对照组比较差异无统计学意义（P〉0．05）。结论外周血MoTF mRNA在ACS中呈高表达，提示血细胞来源的TF在ACS事件中起重要作用。

Objective To observe the levels of tissue factor （TF） in monocyte （Mo） and plasma TF of elderly patients with acute coronary syndrome （ACS） at acute phase and recovery stage. Methods The levels of MoTF mRNA and plasma TF were detected by RT-PCR and ELISA, respectively. Blood samples were taken from 52 acute myocardial infarction （AMI） patients, 45 unstable angina （UA） patients and 50 healthy people. Results Compared with the control group, the expressions of MoTF mRNA （0.258±0.070, 0.304 ± 0.083 and 0.291 ±0.040）, and plasma TFAg levels （ 192.89 ± 91.36,263.14± 114.98 and 258.73±110.12） were significantly higher in AMI and UA group at acute phase（P 〈 0.05）. TF antigen was significantly associated with the expression of MoTF mRNA （P〈 0.05）. At the recovery stage, MoTF mRNA began declining in both AMI and UA groups （0.284±0.048 and 0.279＋0.039）, though they were still significantly higher than the control group （P 〈 0.05）. While plasma TFAg in both AMI and UA groups （212.84±101.36 and 218.74±99.82） decreased significantly to a level that was not significantly different from that in the control group （P 〉 0.05）. Conclusion The expression of TF mRNA in monocytes is upregulated during the onset of ACS.