急性冠状动脉综合征患者外周血内皮细胞及红细胞微粒水平分析

Peripheral blood endothelial cell and red blood cell microparticles in patients with acute coronary syndromes

目的:分析急性冠状动脉综合征(ACS)患者与非冠心病患者外周血红细胞微粒(RMPs)与内皮细胞微粒(EMPs)水平差异及其与临床指标的相关性。方法:纳入2015-2017年入住我院心内科行冠状动脉(冠脉)造影术的患者146例,分为ACS组109例与非冠心病组(对照组)37例。其中ACS包括ST段抬高型心肌梗死(STEMI)38例(STEMI亚组),非STEMI 36例(NSTEMI亚组),不稳定型心绞痛(UA)35例(UA亚组)。收集并比较各组患者一般临床指标及RMPs与EMPs水平。采用多元线性回归分析RMPs、EMPs水平与其他临床指标之间的相关性。结果:ACS组RMPs、EMPs、脂蛋白a[LP(a)]及超敏C反应蛋白(hs-CRP)水平明显高于对照组(均P<0.05)。STEMI亚组与NSTEMI亚组RMPs及EMPs水平均高于UA组(均P<0.05),而STEMI亚组与NSTEMI亚组间RMPs与EMPs水平无显著统计学差异。多元线性回归分析显示,RMPs与EMPs水平分别与LP(a)(β=0.026、0.028,均P<0.05)、hs-CRP(β=0.126、0.136,均P<0.05)、低密度脂蛋白胆固醇(LDL-C)(β=4.418、4.540,均P<0.05)呈正相关。结论:ACS患者RMPs与EMPs水平明显增高,并与hs-CRP、LP(a)及LDL-C水平密切相关。

Objective:To analyze the differences of red blood cell microparticles(RMPs)and endothelial cell microparticles(EMPs)from peripheral blood in patients with acute coronary syndrome(ACS)and non-coronary heart disease(CHD)and their correlation with clinical parameters.Method:A total of 146 patients underwent coronary angiography in our hospital from December 2015 to February 2017 were divided into ACS group(n=109)and non-CHD(control group,n=37).All ACS patients were further divided intoST-segment elevation myocardial infarction(STEMI)subgroup(n=38),non-STEMI(NSTEMI)subgroup(n=36),and unstable angina pectoris(UA)subgroup(n=35).The general clinical indexes and RMPs and EMPs levels were collected and compared in groups.Multiple linear regression was used to analyze the correlation between RMPs,EMPs,and other clinical indicators.Result:Levels of RMPs,EMPs,LP(a),and hs-CRP in ACS group were significantly higher than those in control group(all P<0.05).Levels of RMPs and EMPs in STEMI and NSTEMI subgroups were higher than those in UA subgroup(all P<0.05),but there was no significant difference between STEMI and NSTEMI subgroups.Multiple linear regression analysis showed that RMPs and EMPs were positively correlated with LP(a)(β=0.026,0.028,both P<0.05),hs-CRP(β=0.126,0.136,both P<0.05),and LDL-C(β=4.418,4.540,both P<0.05).Conclusion:Levels of RMPs and EMPs in patients with ACS are significantly increased and closely related to hs-CRP,LP(a),and LDL-C.