ACS患者外周血中vWF-cp、Cat K、CysC及P选择素的变化及与冠脉病变的关系

Changes of vWF-cp,Cat K,CysC and P selectin in peripheral blood of ACS patients and its relationship with coronary artery disease

目的:探讨急性冠脉综合征(ACS)患者外周血中血管性血友病因子裂解酶(vWF-cp)、组织蛋白酶K(Cat K)、胱抑素C(CysC)及P选择素的变化及其临床意义。方法:选取我院心内科确诊的ACS患者90例(ACS组)、稳定性心绞痛患者90例(SAP组)及体检健康对象90例(对照组),收集时间2016年1月至2017年7月,检测三组的血清vWF、Cat K、CysC、P选择素水平,并分析上述指标与ACS患者冠脉病变支数、冠脉Gensini积分的关系。结果:ACS组、SAP组的血清Cat K、CysC、P选择素水平均显著高于对照组(P<0.05),vWF-cp显著低于对照组(P<0.05);ACS组的血清Cat K、CysC、P选择素水平显著高于SAP组(P<0.05),vWF-cp显著低于SAP组(P<0.05);单支、双支及三支病变患者的血清Cat K、CysC、P选择素水平在组间逐渐升高(P<0.05),vWF-cp在组间逐渐降低(P<0.05);ACS患者血清Cat K、CysC、P选择素与Gensini评分呈显著正相关(P<0.05),vWF-cp与Gensini评分呈显著负相关(P<0.05)。结论:ACS患者血清Cat K、CysC、P选择素显著的升高、vWF-cp水平显著降低,并且与冠脉病变程度具有密切关系。

Objective: To investigate the changes and clinical significance of von Willebrand factor cleavage enzyme(vWF-cp), cathepsin K(Cat K), Cystatin C(CysC) and P selectin in peripheral blood of patients with acute coronary syndrome(ACS). Methods: Ninety ACS patients in our hospital department of cardiology diagnosed(ACS group), 90 patients with stable angina pectoris(SAP group) and 90 healthy subjects(control group), from January 2016 to July 2017, were enrolled in the study. The serum levels of vWF,Cat Ky CysCfP selectin were measured in the three groups, and the relationship between the above indexes and the number of coronary artery lesion branches and the coronary Gensini score in ACS patients was analyzed.Results: ACS group, SAP group, Cat K CysC, serum P selectin levels were significantly higher than those in the control group(P<0.05), vWF-cp was significantly lower than the control group(P<0.05);Serum Cat K, CysC, P selectin levels of ACS group were significantly higher than that of SAP group(P<0.05), vWF-cp was lower than those in SAP group(P<0.05);Cat K, CysC, P selectin levels increased gradually while vWF-cp decreased gradually in turn in single, double and three vessel disease groups(P<0.05), ACS K, CysC, Cat in serum of patients with P selectin and Gensini score showed a significant positive correlation(P<0.05), a a significant negative correlation between vWF-cp and Gensini score was also found(P<0.05).Conclusion:The serum levels of Cat K, CysC, P selectin are significantly increased and the level of vWF-cp decreased significantly in ACS patients, which is closely related to the degree of coronary artery disease.