急性冠脉综合征患者血清血小板衍生生长因子表达的临床研究

Clinical study on the expression of serum platelet-derived growth factor in patients with acute coronary syndrome

目的 探讨急性冠脉综合征患者外周血及冠状动脉局部血清血小板衍生生长因子（PDGF）浓度与冠状动脉疾病严重程度的关系.方法 纳入2012年9月至2013年12月在南京医科大学第一附属医院心血管科行冠状动脉造影的急性冠脉综合征患者,并纳入同期因胸痛住院行冠状动脉造影且冠脉未见狭窄者为对照组.收集各组患者临床资料,计算SYNTAX积分,通过ELSIA方法测定患者外周血及冠状动脉局部血清PDGF浓度;分析非冠心病组与冠心病ACS组、ACS患者不同亚组间血清PDGF浓度的差异,利用Pear-son相关性分析血清PDGF浓度与SYNTAX积分的相关性.结果 与对照组比较,冠心病ACS组外周血PDGF浓度显著升高[（723.29±679.53）pg/ml比（369.12.0±292.39）pg/ml,P〈0.05];冠心病ACS组中AMI组外周血PDGF浓度较UAP组显著升高[（758.36±714.56）pg/ml比（614.11 ±600.39）pg/ml,P〈0.05].ACS患者冠状动脉局部PDGF浓度较外周血PDGF浓度显著升高[（911.89±735.41）pg/ml比（723.29±679.53）pg/ml,P〈0.01].Pearson相关分析显示,外周血PDGF浓度与冠脉狭窄程度（SYNTAX评分）呈正相关关系（r=0.233,P〈0.05）.随着血清PDGF浓度的升高,平均SYNTAX积分逐步升高,高浓度组SYNTAX积分高于低PDGF浓度组.结论 急性冠脉综合征患者血清PDGF浓度显著升高,尤其在冠状动脉局部PDGF呈现浓聚.血清PDGF浓度可反映冠状动脉病变的严重程度.

Objective To investigate the relationship between the concentration of PDGF and the severity of coronary artery disease in peripheral blood and coronary arteries of patients with acute coronary syndrome.Methods A total of 81 patients with acute coronary syndromes were enrolled from the department of Cardiovascular in the first affiliated hospital of Nanjing Medical University from September 2002 to December 2013.29 patients with elective coronary angiography because of chest pain act as a control group,without intraoperative coronary stenosis.During CAG or PCI,peripheral arterial blood as well as the distal blood of coronary artery lesions was collected from the ACS patients,while only peripheral arterial blood was collected from the control group.The SYNTAX score of each patient were calculated according to the result of CAG.The levels of PDGF in the peripheral blood and coronary arteries were measured by ELS1A method.The relationship between serum PDGF concentration and SYNTAX score was analyzed by Pearson correlation analysis.Results Compared with the control group,the concentration of PDGF in the peripheral blood of ACS group was significantly higher than that of the control group [（723.29±679.53）pg/ml vs.（369.12.0±292.39）pg/ml,P〈0.05].The average concentration of PDGF in peripheral blood of AMI patients was significantly higher than that of UAP group high [（758.36±714.56） pg/ml vs.（614.11±600.39）pg/ml,P〈0.05].The concentration of PDGF in the coronary arteries was significantly higher than that in the peripheral blood [（911.89-±735.41）pg/ml vs.（723.29±679.53）pg/ml,P〈0.01].Pearson correlation analysis showed a significant positive correlation between peripheral blood PDGF concentration and the severity of coronary stenosis（SYNTAX score）（r=0.233,P〈0.05）.With the increase of serum PDGF concentration,the mean SYNTAX score was increased gradually,and the SYNTAX score in high PDGF concentration group was higher than that in low PDGF group.Conclusion The concentration of PDGF is significantly increased in patients with acute coronary syndrome,especially in the local of coronary artery,and the concentration of PDGF can reflect the severity of coronary artery disease.