急性冠脉综合征患者血栓弹力图及血浆环氧二十碳三烯酸与冠状动脉狭窄程度相关性分析

The correlation between thromboelastography, plasma EETs and the degree of coronary artery stenosis in patients with acute coronary syndrome

目的分析急性冠脉综合征(ACS)患者血栓弹力图(TEG)参数及血浆环氧二十碳三烯酸(EETs)水平与冠状动脉狭窄程度的相关性。方法选择2018年11月~2020年1月在我院住院的ACS患者126例,其中不稳定型心绞痛(uA)组57例,非ST段抬高型心肌梗死(NSTEMI)组30例,ST段抬高型心肌梗死(STEMI)组39例,根据Gensini评分将患者按冠状动脉狭窄程度分成轻度组(33例)、中度组(48例)和重度组(45例)。检测患者TEG参数(α角、MA值、R值、K值)及血浆EETs水平,对比各组间TEG参数及EETs水平差异。结果uA组、NSTEMI组和STEMI组间TEG参数及EETs水平差异均有统计学意义(P<0.05)。冠状动脉狭窄轻度组、中度组和重度组间TEG参数及EETs水平差异均有统计学意义(P<0.05)。Pearson相关性分析显示,ACS患者冠状动脉狭窄程度与TEG参数中R值、K值及EETs水平呈负相关(r=-0.316、-0.379、-0.481,P<0.01);与α角、MA值呈正相关(r=0.362、0.346,P<0.01)。结论TEG参数及血浆EETs水平可反映ACS的严重程度及冠状动脉狭窄程度,血浆EETs是冠心病的保护性因素,TEG对ACS的早期诊断有一定参考价值。

Objective To investigate the correlation between thromboelastography(TEG)parameters,plasma EETs and the degree of coronary artery stenosis in patients with acute coronary syndrome(ACS).Methods A total of 126 ACS patients hospitalized in our hospital from Nov 2018 to Jan 2020 were enrolled,including 57 cases of unstable angina(uA)(uA group),30 cases of non-ST segment elevation myocardial infraction(NSTEMI)(NSTEMI group)and 39 cases of ST segment elevation myocardial infraction(STEMI)(STEMI group).The patients were divided into mild group(33 cases),moderate group(48 cases)and severe group(45 cases)according to Gensini score.The TEG parameters(αangle,MA value,R value,K value)and EETs levels of all subjects were tested,and the differences of TEG parameters and EETs levels among each group were compared.Results There were statistically significant differences in TEG parameters and EETs levels among u A,NSTEMI and STEMI groups(P<0.05).There were statistically significant differences in TEG parameters and EETs levels among the mild,moderate and severe groups(P<0.05).Pearson correlation analysis showed that the R value,K value and plasma EETs level were negatively correlated with the degree of coronary artery stenosis(r=-0.316,-0.379,-0.481,P<0.01),while theαangle and MA value were positively correlated with the degree of coronary artery stenosis(r=0.362,r=0.346,P<0.01).Conclusion The TEG parameters and plasma EETs level can reflect the severity of ACS and the degree of coronary artery stenosis,plasma EETs is a protective factor for coronary heart disease,TEG is valuable for early diagnosis of ACS.