炎性因子与急性冠状动脉综合征及颈动脉复杂斑块相关  

Clinical Study of the Relationship among Inflammatory Markers, Acute Coronary Syndrome, and Carotid Atherosclerotic Plaque

作　　者：程文立[1] 柯元南[1] 王勇[1] 陈莉[1] 范书英[1] 

机构地区：[1]卫生部中日友好医院心血管病中心,北京市100029

出　　处：《中国动脉硬化杂志》2006年第9期795-798,共4页Chinese Journal of Arteriosclerosis

摘　　要：目的 研究急性冠状动脉综合征与颈动脉易损斑块之间是否相关.方法 92例急性冠状动脉综合征患者和97例稳定型心绞痛患者均接受冠状动脉造影检查,40例正常者为对照.采用高分辨率超声测定患者颈动脉内膜中膜厚度、双侧颈动脉粥样斑块数和斑块的特征,采用酶联免疫吸附法测定血浆基质金属蛋白酶9、细胞间粘附分子1和高敏C反应蛋白的浓度.结果 急性冠状动脉综合征患者基质金属蛋白酶9、细胞间粘附分子1和高敏C反应蛋白均显著高于稳定型心绞痛和正常对照者,具有颈动脉复杂斑块的急性冠状动脉综合征患者显著高于稳定型心绞痛与正常对照者,Logistic多元回归分析发现,高敏C反应蛋白＞4.0 mg/L（OR为5.37,95%CI为1.43～15.21, P=0.003）、基质金属蛋白酶9＞300 μg/L（OR为3.12, 95%可信限为1.11～8.98, P=0.027）、细胞间粘附分子1＞200 μg/L（OR为4.78,95%可信限为1.34～9.89, P=0.010）、体质指数＞24（OR为1.78,95%可信限为1.12～2.67,P=0.04）、急性心肌梗死 （OR为3.37,95%可信限为1.66～8.91,P=0.008）、不稳定型心绞痛（OR为3.31,95%可信限为1.22～9.88, P=0.011）均与颈动脉复杂斑块相关.结论 急性冠状动脉综合征患者颈动脉易损斑块数目显著高于稳定型心绞痛患者和正常对照者,急性冠状动脉综合征与颈动脉易损斑块有相关关系.Aim To explore whether there is relationship among the inflammation markets, acute coronary syndrome （ACS） and carotid atherosclerotic plaque. Methods 92 patients with ACS, 97 patients with stable angina pectofis （SAP） who underwent coronary angiography were enrolled in our study, 40 healthy people were selected as control. The bilateral carotid ultrasounding by high sensitive was investigated to measure the intima-media thickness （IMT）, the number of the carotid plaques and the characteristics of the plaques, the serum levels of intercellular adhesion molecular- 1 （ ICAM- 1 ）, matrix metalloproteinase- 9 （MMP-9） and high sensitive C-reaction protein （hs-CRP） were determined and the Logistic statistic analysis was used to study the relationship of the inflammatory markers and the unstable plaque. Results The levels of MMP-9, ICAM-1 and hs-CRP in the patients with ACS were significantly higher than those of the patients with SAP and the normal people. According to the Logistic analysis, the results indicated that serum MMP-9, ICAM-1 and hs-CRP were related to the trustable plaque （MMP-9 〉 300 μg/L, OR： 3.12, 95%CI： 1.11-8.98, P=0.027; ICAM-1 〉200μg/L, OR： 4.78, 95%CI： 1.34-9.89, P=0.010; hs-CRP 〉4.0mg/L, OR： 5.37, 95%CI： 1.43-15.21, P=0.003）. Conclusion The numbers of the complex carotid plaques in patients with ACS were signifleanfly higher than those of the patients with SAP and normal control people, There was significant relationship between the complex carotid plaques and ACS.

关 键 词：内科学 急性冠状动脉综合征 高分辨率超声 基质金属蛋白酶9 细胞间粘附分子1 高敏C反应蛋白 

分 类 号：R5[医药卫生—内科学]