冠心病患者血浆胆固醇与内皮素-1 C-反应蛋白及血小板可溶性P选择素相关性研究──附56例报告

The correlations between the plasma cholesterols and endothelin-1, C-reactive protein, soluble P-selectin of platelet in patients with coronary atherosclerotic heart disease.

目的 :了解冠状动脉粥样硬化性心脏病 (冠心病 )患者血浆胆固醇与内皮素 1、C反应蛋白 (C reactiveprotein ,CRP)及血小板可溶性P选择素 (solubleP selectin ,sP selectin)的关系。方法 :检测5 6例急性冠状动脉综合征 (acutecoronarysyndrome,ACS)、 2 3例慢性稳定型心绞痛 (chronicstableangina ,CSA)患者和对照组 10名正常人血浆总胆固醇、LDL C、内皮素 1、CRP和血小板sP selectin水平。结果 :ACS组血浆内皮素 1[(5 2± 10 )ng/L]、CRP水平 [(2 0± 9)mg/L]与CSA组 [(4 3± 4 )ng/L ,(13± 5 )mg/L]和正常对照组 [(36± 10 )ng/L ,(8± 2 )mg/L]比较差异均有统计学意义 ,均为P <0 0 1。血浆sP selectin水平ACS组 [(15 9± 5 8) μg/L]与CSA组 [(12 9± 1 9) μg/L]比较、CSA组与正常对照组[(6 7± 2 9) μg/L]比较 ,差异均有统计学意义 ,均为P <0 0 1。ACS组血浆总胆固醇、LDL C分别与内皮素 1、CRP、sP selectin呈正相关 [(r=0 2 9,P <0 0 5 ;r=0 5 6 ,P <0 0 1) ,(r=0 4 9,r =0 5 0 ,均为P<0 0 1) ,(r=0 30 ,P <0 0 5 ;r=0 5 4 ,P <0 0 1) ];CSA组血浆LDL C与CRP呈正相关 (r =0 4 7,P <0 0 5 )。结论 :ACS患者的血浆胆固醇可能有加重内皮功能障碍。

Objective: To study the correlations between the plasma levels of cholesterols and endothelin-1(ET-1), C-reactive protein (CRP), soluble P-selectin (sP-selectin) of platelet in the patients with coronary atherosclerotic heartdisease. Methods: The plasma levels of total cholesterol (TC), LDL-C, ET-1, CRP, sP-selectin were measured in 56 patients with acute coronary syndrome (group ACS), 23 patients with chronic stable angina(group CSA), and 10 healthy persons (normal controls).Results: The plasma levels of ET-1,CRP[(52±10) ng/L,(20±9) mg/L, respectively]in group ACS were markedly elevated compared to the CSA[(43±4) ng/L,(13±5) mg/L, respectively] and normal controls[(36±10)ng/L,(8±2)mg/L, respectively] (P<0.01,P<0.01). The levels of sP-selectin in group ACS(15.9±5.8 μg/L) were higher than that in group CSA(12.9±1.9 μg/L)(P<0.01), and that in group CSA was higher than that in normal controls(6.7±2.9 μg/L)(P<0.05). Significant positive correlations between the plasma TC, LDL-C and ET-1(r=0.29,P<0.05;r=0.56,P<0.01), CRP(r=0.49,P<0.01;r=0.50,P<0.01), sP-selectin (r=0.30,P<0.05;r=0.54,P<0.01) were observed in the group ACS. There was only a positive correlation between the plasma LDL-C and CRP(r=0.47,P<0.05) in group CSA.Conclusion: The plasma cholesterols may exacerbate the endothelial dysfunction, aggravate the systemic inflammation and activate the platelet in the patients with ACS.