急性冠脉综合征患者血清甲壳质酶蛋白-40与P选择素及hsCRP水平的相关性

Correlation among serum levels of P-selectin,high sensitive C reactive protein and chitinase protein-40 in patients with acute coronary syndrome

目的:探讨急性冠脉综合征(ACS)患者血清甲壳质酶蛋白-40(YKL-40)与P选择素及高敏C反应蛋白(hsCRP)水平的变化及其相关性。方法:选择160例冠心病患者[ACS患者80例、稳定型心绞痛(SAP)患者80例]、80例非冠心病患者(正常对照组),采用酶联免疫吸附法测定各组血清YKL-40、P选择素及hsCRP水平,并进行比较分析。结果:与正常对照组及SAP组比较,ACS组血清YKL-40[(20.92±3.19)ng/ml比(45.18±3.96)ng/ml比(61.84±3.51)ng/ml]、P选择素[(65.01±16.18)μg/L比(97.58±31.43)μg/L比(137.41±48.26)μg/L]及hsCRP[(6.91±3.68)mg/L比(8.32±4.21)mg/L比(30.01±11.05)mg/L]水平均明显升高(P均=0.001)。直线相关分析显示,P选择素、hsCRP与YKL-40水平呈显著正相关(r=0.46,0.41,P=0.021,0.015)。结论:急性冠脉综合征患者血清甲壳质酶蛋白-40,P选择素及hsCRP水平显著升高,提示这三指标与粥样斑块不稳定性相关,可作为判断粥样斑块不稳定性的血清学指标。

Objective:To explore changes of serum levels of chitinase protein-40(YKL-40),P-selectin and high sensitive C reactive protein(hsCRP)in patients with acute coronary syndrome(ACS)and their correlation.Methods:A total of 160 patients with coronary heart disease(CHD),including 80 ACS cases and 80 cases with stable angina pectoris(SAP),were selected.Another 80 non-CHD patients were enrolled as normal control group.Serum levels of YKL-40,P-selectin and hsCRP were measured by enzyme linked immunosorbent assay and compared among all groups.Results:Compared with normal control group and SAP group,there were significant rise in serum levels of YKL-40[(20.92±3.19)ng/ml vs.(45.18±3.96)ng/ml vs.(61.84±3.51)ng/ml],P-selectin[(65.01±16.18)μg/L vs.(97.58±31.43)μg/L vs.(137.41±48.26)μg/L]and hsCRP[(6.91±3.68)mg/L vs.(8.32±4.21)mg/L vs.(30.01±11.05)mg/L]in ACS group,P=0.001 all.Linear correlation analysis indicated that serum P-selectin and hsCRP levels was significant positively correlated with serum YKL-40 level(r=0.46,0.041,P=0.021,0.015).Conclusion:Serum levels of YKL-40,P-selectin and hsCRP significantly rise in ACS patients,suggesting that these indexes are related to atherosclerotic plaque instability,which can be used as serological indexes judging atherosclerotic plaque instability.