冠心病患者血清黏附分子增高的临床意义  

Change of serum adhesion molecules in patients with coronary heart disease

作　　者：蓝景生[1] 黄照河[1] 潘兴寿[1] 

机构地区：[1]右江民族医学院附属医院心内科,广西百色533000

出　　处：《临床荟萃》2005年第15期856-858,共3页Clinical Focus

摘　　要：目的观察冠心病不同临床类型患者可溶性细胞黏附分子-I(sICAM-I)和血管细胞黏附分子-I浓度(sVCAM-I)的变化,以探讨sICAM-I、sVCAM-I与冠状动脉循环时间(CCT)和不同的冠状动脉狭窄程度的关系。方法急性心肌梗死(AMI)21例、不稳定型心绞痛(UAP)28例、稳定型心绞痛(SAP)38例患者行冠状动脉造影术,测定冠状动脉循环时间和计算冠状动脉狭窄程度。根据CCT分成两组:<0.50s组39例,>0.50s组48例;再按冠状动脉狭窄程度分为3组:轻度组33例,中度组29例,重度组25例。采用酶联免疫吸附法测定血清中sICAM-I、sVCAM-I,并与29例年龄、性别相当的健康体检者进行比较。结果AMI患者sICAM-I及sVcAM-I浓度的平均秩次(87.90vs84.90)高于UAP者(74.70vs71.96);UAP者高于SAP者(54.70vs54.07);SAP者高于对照组(27.65vs32.17);CCT<0.50s组sICAM-I、sVCAM-I的平均秩次(39.64,41.72)低于CCT>0.50s组(47.54,45.85),CCT长的冠心病患者血中sICAM-I及sVCAM-I浓度增高;重度及中度冠状动脉狭窄组sICAM-I(689.0±192.8μg/L,705.0±157.6μg/L)高于轻度组(586.0±134.4μg/L),sVCAM-I浓度与冠状动脉狭窄程度无关。结论sICAM-I、sVCAM-I浓度与冠心病危重以及CCT有关,sICAM-I可能与冠状动脉狭窄程度有关,血清中sICAM-I、sVCAM-I可反映冠心病的临床和冠状动脉循环的状况。Objective To investigate the change of soluble intercellular adhesion molecules-I(sICAM-I), soluble vascular cell adhesion molecules-I(sVCAM-I) in various clinical presentations of coronary heart disease and explore sICAM-I,sVCAM-I association with coronary circulation time(CCT) and the degree of coronary artery stenosis. Methods Twenty-one patients with acute myocardial infarction(AMI),28 patients with unstable angina pectoris(UAP), 38 patients with stable angina pectoris(SAP)were divided into two groups according to CCT: < 0.50 s group,39 cases and > 0.50 s group, 48 casess;according to the degree of coronary artery stenosis, there were three groups: minor group,33 cases, moderate group,29 cases; serious group,25 cases.sICAM-I and sVAM-I were detected with enzyme linked immune absorption assay. Twenty-nine healthy persons served as controls. Results sICAM-I and sVCAM-I average rank were significantly higher in patients with AMI( 87.90 , 84.90 ) than those with UAP( 74.70 , 71.96 ) and SAP( 54.70 , 54.07 ) and control group( 27.65 , 32.17 ). sICAM-I, sVCAM-I average rank in CCT< 0.50 s group( 39.64 , 41.72 ) was lower than CCT> 0.50 s group( 47.54 , 45.85 ). In addition, sICAM-I in serious group and moderate group ( 689.0 ± 192.8 μg/L, 705.0 ± 157.6 μg/L) was higher than minor group ( 586.0 ± 134.4 μg/L). sVCM-I level has no correlation with the degree of coronary artery stenosis. Conclusion The levels of sICAM-I and sVAM-I may link to presentations of coronary heart disease,coronary circulation time and the degree of coronary artery narrow.

关 键 词：冠状动脉疾病 细胞黏着分子 冠状血管造影术 

分 类 号：R541.4[医药卫生—心血管疾病]