冠心病患者循环内皮细胞内皮脂肪酶表达与冠脉危险积分的关系及意义  

Correlation between the expression of endothelial lipase in CECs and the improved jeopardy score in CAD patients

作　　者：方玉强[1] 黄岚[1] 李爱民[1] 宋耀明[1] 晋军[1] 耿昭华[1] 于学军[1] 林春梅[1] 陶春蓉[1] 

机构地区：[1]解放军第三军医大学新桥医院全军心血管病研究所,重庆400037

出　　处：《中国急救医学》2008年第1期5-8,99,共5页Chinese Journal of Critical Care Medicine

基　　金：国家自然科学基金资助项目(No.30470729)

摘　　要：目的检测冠心病患者循环内皮细胞(CEC)内皮脂肪酶(EL)的表达,探讨循环内皮细胞EL与冠脉病变的关系及临床意义。方法107例急性冠脉综合征(ACS)患者和69例稳定型心绞痛(SAP)患者经冠脉造影证实有明显冠脉狭窄;经临床检查和选择性冠脉造影选择82例为对照组。采集肘静脉血液标本,分离并测定CECs计数,以免疫组化和Westernblot法检测循环内皮细胞中EL的表达,并计算EL阳性CECs比例(EL+/CECs),按改进的冠脉危险积分(jeopardyscore)法评价冠脉病变情况。结果ACS患者改进冠脉危险积分、hsCRP、CECs计数、EL+/CECs显著高于对照组(P<0.05),SAP组hsCRP、CECs计数、EL+/CECs与ACS组比较差异也有统计学意义(P<0.05),改进冠脉危险积分与EL+/CECs、hsCRP、CECs计数有相关性(P<0.001,P<0.01)。结论冠心病患者内皮细胞表达的EL可能参与冠心病的发病,EL+/CECs高者提示患者可能存在冠脉狭窄。Objective To detect the expression of endothelial lipase in the endothelial cells and its correlations with the patients of stable angina pectoris（SAP）or acute coronary system（ACS）.Methods The 107 patients with ACS,69 patients with SAP and 82 patients without coronary artery disease（control）were studied.Blood samples were collected from ulnar wein and circulating endothelial cells（CECs）were separated,the number of CEC was calculated and the expression of endothelial lipase（EL）in CECs were detected by immmunohistochemistry and Western blot,the percentage of positive endothelial lipase/CECs（EL^＋/CECs）were calculated.The improved jeopardy score for coronary artery lesion was evaluated according to the method introduced by Califf.Results In coronary artery diseases patients,especially in ACS patients,the EL^＋/CECs,improved jeopardy score,hsCRP and the number of CECs were higher than those in control group（P〈0.05）.There was significant difference in EL^＋/CECs,hsCRP and CEC count between SAP and ACS groups（P〈0.05）.The EL^＋/CECs,hsCRP and the CEC count were positively correlated with the improved jeopardy scores（P〈0.001）.Conclusion The expression of EL in endothelial cell may play a key role in the progression of coronary artery disease,high EL^＋/CECs show that there is lesion in the coronary artery.

关 键 词：冠心病 冠脉病变危险积分 内皮脂肪酶 循环内皮细胞计数 

分 类 号：R541.4[医药卫生—心血管疾病]