急性冠脉综合征患者外周血白细胞表面粘附分子的表达

EXPRESSION OF LEUKOCYTES ADHESION MOLECULES IN PATIENTS WITH CORONARY ARTERY SYNDROME

目的 研究急性冠脉综合征患者外周血中性粒细胞和单核细胞表面粘附分子CD11b、CD18的表达。方法 选择 5 4例急性冠脉综合征患者 ,其中 2 5例为急性心肌梗死患者 ,2 9例为不稳定心绞痛患者。根据疼痛的严重程度将不稳定心绞痛患者按Braunwald分级分为三组 :第一组 (9例 ) ,BraunwaldⅠ级 ;第二组 (8例 )BraunwaldⅡ级 ;第三组 (12例 )BraunwaldⅢ级。选择 12例健康人为正常对照组。采用流式细胞术分析外周血中性粒细胞和单核细胞表面CD11b、CD18的表达。结果 急性冠脉综合征患者外周血中性粒细胞和单核细胞表面CD11b、CD18的表达较正常对照组显著升高 (P <0 .0 0 1) ;不稳定心绞痛患者由第一组到第三组外周血中性粒细胞和单核细胞表面CD11b、CD18的表达是逐渐升高的 ,其中第三组较第一组明显升高 (P <0 .0 5 )。结论 冠心病患者外周血白细胞是激活的 ;随着不稳定心绞痛病情的加重 ,外周血白细胞活性也是增加的 ,白细胞活性状态可能提示了病变斑块存在着炎症反应。

Objective\ To study examining the expression of neutrophil and monocyte adhesion molecules CD11b and CD18 antigens in patients with acute coronary syndromes. Methods\ The study population included 54 patients with acute coronary syndromes. Among them, 25 patients were diagnoses as acute myocardial infarction, 29 patients were unstable angina. 12 healthy members served as control group. Patients with unstable angina were divided into three groups: group 1 ( n =9, Braunwald′s classⅠ ); group 2( n =8, Braunwald′s class Ⅱ ); group 3(n =12, Braunwald′s class Ⅲ). The expression of CD11b and CD18 antigens was determined by flow cytometry. Results\ The patients with acute coronary syndromes had significantly higher concentration of CD11b and CD18 antigens on the surface of peripheral polymorphonuclear leukocytes and monocytes compared with the control group ( P<0.001). The expression of CD11b and CD18 on the surface of peripheral polymorphonuclear leukocytes and monocytes in patients with unstable angina increased from group 1 through 2 to 3, the concentration of CD11b and CD18 in patients of group 3 was significantly higher than that of group 1 ( P <0.05). Conclusion\ The presence of increased concentration of CD11b and CD18 suggests that circulating leukocytes are activated in patients with coronary artery disease; The activation of leukocytes is related with the severity of unstable angina; This activation probably reflects the presence of an inflammatory response involving the atherosclerotic lesion.