单核细胞趋化蛋白-1对不稳定型心绞痛患者近期心血管事件的预测价值  

Predictive Value of Monocyte Chemoattractant Protein-1 for Cardiovascular Events in Patients with Unstable Coronary Artery Disease

作　　者：吕春美[1] 彭子敬[1] 田国平[1] 

机构地区：[1]湖南省邵阳市第一人民医院心血管内科,湖南邵阳422000

出　　处：《医学临床研究》2008年第4期664-666,669,共4页Journal of Clinical Research

摘　　要：[目的]探讨高水平的单核细胞趋化蛋白-1（MCP-1）对不稳定型心绞痛（UA）患者近期心血管不良事件的预测价值。[方法]采用酶联免疫吸附试验法分别测定196例UA，30例稳定型心绞痛患者（SAP）。30例非冠心病者（N）外周血MCP-1水平。比较三组MCP-1水平变化，根据MCP-1中位值水平将UA患者分成两组，随访两组UA患者近半年心血管不良事件发生情况，比较不良事件发生率。[结果]①UA组MCP-1水平[（172．63±18．27）Pg／mL]高于SAP组[（135．25±13．61）pg／mL]（P〈0．001），SAP组[（135．25±13．61）ph／mL]高于正常对照组[（116.67±6．21）pg／mL]（P〈0．001）；②随访半年，196例UA患者共有23例发生心血管不良事件，其中高MCP-1组近期心血管不良事件发生率明显高于较低MCP-1组（22．6％ vs 9．8％），高MCP-1的相对危险度为2．15，95％CI（1．67～3．28）（P〈0．05）。[结论]MCP-1是UA患者近期心血管不良事件的预测因子，高水平的MCP-1可预警UA患者近期心血管不良事件的发生。[Objective] To investigate the predictive value of monocyte chemoattractant protein-1 （MCP-1） for cardiovascular events in patients with unstable coronary artery disease （UA）. [Methods] One hundred and ninety eight patients who underwent coronary angiography were enrolled in this study. They were divided into three groups： UA group （ n = 136）, SAP group （ n =30） and the control group（ n =30）. Blood samples were taken from the artery before angiography in all patients. Each subject was sought in details of history of hypertension, hyperlipidemia, diabetes and smoking habits. The concentration of MPO was measured by enzyme-linked immunosorbent assays （ELISA）. The UA group was divided into two groups according to the levels of MCP-1, and the cardiovascular events （myocardial infarction and the need for revascularization or death） of the UA patients were recorded after 6 months of follow-up. [Results] Median plasma MCP-1 level in UA group（172.63±18.27 pg/mL） was significantly higher than that in SAP group （135.25±13.61 pg/mL） and the controlgroup（116.67±6.21 pg/mL） （P〈0.001） , and median plasma MCP-1 level in patients of SAP group was significantly higher than that in the control group（ P 〈0. 001）. Twenty-three patients had cardiovascular events. Cardiovascular events was significantly higher in elevated MCP-1 group （22.6 % vs 9.8 % ） whose adjusted relative risk was 2.15 and CI was 95 % （1.67 to 3.28） （ P 〈0.05）. [Conclusion] MCP-1 is an important predictor of short-term cardiovascular events in patients with unstable angina. Plasma elevated MCP-1 levels powerfully predict an increased risk for subsequent cardiovascular events.

关 键 词：单核细胞化学吸引蛋白质1/血液 心绞痛 不稳定型/诊断 预后 

分 类 号：R541.405.3[医药卫生—心血管疾病]