高敏C反应蛋白、细胞凋亡因子和血友病因子对急性冠状动脉综合征进程的影响  

High sensitivity C-reactive protein,soluble cell apoptosis factor Fas and von Willebrand factor in patients with acute coronary syndrome

作　　者：常学伟[1] 张菲斐[1] 张娆娆[1] 魏毅东[2] 魏经汉[1] 

机构地区：[1]郑州大学第一附属医院心血管内科,河南郑州450052 [2]同济大学附属第十人民医院心血管内科,上海200072

出　　处：《临床荟萃》2008年第10期729-732,共4页Clinical Focus

基　　金：河南省医学科技攻关计划项目(20060045)

摘　　要：目的观察急性冠状动脉综合征(ACS)患者血浆高敏C反应蛋白(hsCRP)、可溶性细胞凋亡因子(sFas)和血管性血友病因子(vWF)的变化,探讨凋亡、炎症对冠状动脉粥样硬化进程的影响。方法ACS患者45例,其中急性心肌梗死(AMI)20例,不稳定型心绞痛(UA)25例,同期入选稳定型心绞痛(SA)20例和对照组20例,用酶联免疫吸附试验(ELISA)测定血浆hsCRP、sFas和vWF水平。结果与对照组和SA组相比,AMI组和UA组hsCRP、sFas和vWF水平显著升高(P<0.01);低密度脂蛋白胆固醇、vWF、sFas和hsCRP是ACS的独立危险因素,其相对危险度分别为9.478、1.026、1.569和2.200;ACS组sFas与vWF、hsCRP、纤维蛋白原(FIB)呈正相关(P<0.01),hsCRP与FIB呈正相关(P<0.01)。多元逐步回归分析显示,对Gensini评分和FIB的主要影响因素分别为vWF与年龄和hsCRP与sFas,而vWF主要受sFas和年龄的影响。结论细胞凋亡、炎症可以促进血管内皮损伤和血栓形成,增加动脉粥样硬化斑块的不稳定性,加快ACS的进展。Objective To investigate the changes of high sensitivity C-reactive protein （hsCRP）, soluble cell apoptosis factor Fas（sFas） ,von Willebrand factor（vWF） in acute coronary syndrome（ACS） and to explore the effect of apoptosis and inflammation. Methods Plasma hsCRP,sFas and vWF were measured by enzyme linked immunosorbent assay（ELISA） in 20 control subjects,20 cases of stable angina（SA）,20 cases of unstable angina（UA） and 25 cases of acute myocardial infarction（AMI）. Results hsCRP,sFas and vWF were significantly higher in AMI group and UA group than in control group and SA group （ P 〈0.01）. Based on multiple stepwise logistic regression analysis, low density lipoprotein cholesterol, vWF, sFas and hsCRP were independent risk factors of ACS, respectively, the relative ratio were 9. 478,1. 026,1. 569 and 2. 200. The level of sFas was correlated positively with hsCRP, vWF and fibrinogen （FIB） in ACS （ P 〈0.01）. The stepwise regression analysis showed the main influencing factors to Gensiniscore and FIB were vWF to age,hsCRP to sFas,while vWF was mainly influenced by sFas and age. Conclusion Apoptosis and inflammation may cooperate, which contributes to coagulation and endothelial injury, promotes the pathogenesis of ACS.

关 键 词：冠状动脉疾病 细胞凋亡 C反应蛋白质 血管性血友病因子 

分 类 号：R541.4[医药卫生—心血管疾病]