急性冠脉综合征患者红细胞微粒水平与冠脉病变严重程度的关系

Relationship between Erythrocyte Particle Size and Severity of Coronary Artery Disease in Patients with Acute Coronary Syndrome

目的探讨急性冠脉综合征患者外周血红细胞微粒水平与冠状动脉病变严重程度的相关性及影响因素。方法选择2016年6月~2017年2月收入笔者医院心内科行冠状动脉造影术的患者140例作为研究对象,分为急性冠脉综合征组(ACS组)108例(其中单支病变组25例,双支病变组27例,3支病变组27例,多支病变组29例)和非冠心病组32例,每个患者入院后第二天空腹抽取外周静脉血,分析血脂、血常规、生化指标等,并经流式细胞仪定量分析各组红细胞微粒CD235a表达水平,并根据冠状动脉造影检结果计算Gensini积分。结果与非冠心病组相比较,急性冠脉综合征组患者红细胞微粒(44.37%±15.48%)、低密度脂蛋白胆固醇(3.18±1.16mg/L)、脂蛋白a(215.23±183.10mg/L)、超敏C反应蛋白(19.58±26.94mg/L)水平均明显升高,差异有统计学意义(P<0.05)。急性冠脉综合征组各亚组间比较红细胞微粒与低密度脂蛋白胆固醇水平差异有统计学意义(P<0.05),其中有多支血管病变组红细胞微粒水平及低密度脂蛋白胆固醇水平最高(P<0.05)。ACS组Gensini积分与红细胞微粒水平呈正相关(β=2.157,P<0.05),与高密度脂蛋白呈负相关(β=-15.579,P<0.05)。结论急性冠脉综合征患者红细胞微粒水平明显高于非冠心病患者,红细胞微粒水平与高密度脂蛋白胆固醇与冠状动脉病变严重程度密切相关,红细胞微粒水平对预测急性冠脉综合征冠状动脉变严重程度具有较高的价值。

Objective To investigate the the level of red blood cell microparticls in patients with acute coronary syndromes and the correlation with severity of coronary artery disease and with its influencing factors. Methods A total of 140 patients were sdected into our study from Jun 2016 to Feb 2017.All patiens were identified through coronary angiography. There were 108 patients with acute coronary syndromes （ACS） mentioned as experimental group, which including 25 patients with single vessel disease, 27 patients with double vessel disease, 27 patients with triple vessel disease and 29 cases of multi-vessel disease, and 32 patients of non-coronary heart disease group mentioned as control group. Each patient was fasting and drawn the periheral venous blood after the next day of hospitalized then analyzing blood lipids, blood routine and biochemical indicators.The expression of CD235a in erythrocyte derived microparticles was quantitatively analyzed by flow cytometry. The Gensini score was calculated based on the Results of coronary angiography. Results Compared with the non-CHD group, the levels of red blood cells microparticles （44.37%±15.48%）, low density lipoprotein cholesterol （3.18±1.16mg/L）, lipoprotein a （215.23±183.10mg/L） and high sensitivity C Protein （19.58±26.94mg/L） were significantly increased, and the difference was statistically significant （P〈0.05）. The levels of erythrocyte microparticles and low-density lipoprotein cholesterol in the subgroups of acute coronary syndromes were statistically significant （P〈0.05）, with erythrocyte microparticles levels and low-density lipoprotein cholesterol levels （P〈0.05）. There was a positive correlation between Gensini score and erythrocyte drived microparticls （β=2.157,P〈0.05）, and negatively correlated with high density lipoprotein （β=-15.579,P〈0.05）. Conclusion The level of Gensini scores were calculated based on the results of coronary angiography.That in patients with acute coronary syndrome is significantly higher than that in patients with non-coronary heart disease. The level of erythrocyte derived microparticls is closely related to the severity of coronary artery disease. The level of erythrocyte derived microparticls has a high value in predicting the severity of coronary artery disease in acute coronary syndromes.