可溶性血栓调节蛋白在急性冠脉综合征中的临床意义  

The clinical significance of soluble thrombomodulin in acute coronary syndrome

作　　者：廖新学[1] 李欣[2] 王礼春[1] 何健桂[1] 董吁刚[1] 杜志民[1] 马虹[1] 

机构地区：[1]中山大学附属第一医院心内科,广州510080 [2]中山大学附属第一医院急诊科,广州510080

出　　处：《中国医师进修杂志》2008年第7期7-9,共3页Chinese Journal of Postgraduates of Medicine

基　　金：广东省科技计划项目（2004B30601016、2006B36004010）;广东省自然科学基金（5001676）;广东省科委基金资助项目（9840924）

摘　　要：目的测定急性冠脉综合征（ACS）患者可溶性血栓调节蛋白（sTM）水平并探讨其临床意义。方法用ELISA法测定48例ACS患者（ACS组）及10例对照者（对照组）sTM水平，并对冠状动脉造影结果、各种冠心病危险因子和主要心脏不良事件与sTM水平之间的关系进行统计分析。结果ACS组sTM水平高于对照组[（3．67±1．71）μg/L比（2．34±0．43）μg／L，P〈0．05]。危险因子数〉2个患者的sTM水平高于危险因子数≤2个患者[（4．93±2．76）μg/L比（3．13±0．81）μg/L，P〈0．05]；病变血管数〉2支患者的sTM水平高于病变血管数≤2支患者[（4．60±2．83）μg/L比（2．91±0．23）μg/L，P〈0．05]。sTM〉3．2 μg/L患者的主要心脏不良事件发生率显著高于sTM≤3．2μg/L患者（70．0％比35．7％，P〈0．05）。结论sTM水平是反映内皮细胞损伤程度和范围的良好标志，它与冠心病危险因子的损伤作用有关，并对ACS的病变范围和预后有提示意义。Objective To study the levels of soluble thrombomodulin （sTM）in patients with acute coronary syndrome （ACS） and evaluate its clinical significance. Method Measured the sTM levels with enzyme linked immunosorbent assay, and described the characteristics of coronary arteriography, risk factors of coronary heart disease, and adverse events in a case-control study of 48 ACS patients （ACS group）and 10 normal people （control group）. Results The level of sTM in ACS group was （3.67 ± 1.71 ） μg/L, and （2.34 ± 0.43 ）μg/L in control group （ P 〈 0.05 ）. The level of sTM in the patients of risk factors or impaired vessels number more than 2 increased significantly than those in the patients of risk factors or impaired vessels number inferior or equal to 2, （4.93±2.76） μg/L vs （3.13±0.81） μg/L, P〈0.05, （4.60± 2.83） μg/L vs （2.91 ± 0.23） μg/L, P〈 0.05 respectively. The incidence of cardiac events in the patients of sTM more than 3.2 Ix g/L （70.0%）was higher significantly than that in the patients of sTM inferior or equal to 3.2 μg/L（35.7%）, P〈 0.05. Conclusions The levels of sTM are valuable markers to evaluate the impaired degree and scope of endothelial cells in ACS. They are also associated with the number of risk factors, and useful in predicting the extent and prognosis of the disease.

关 键 词：血栓调节蛋白 内皮细胞 冠脉综合征 

分 类 号：R541.4[医药卫生—心血管疾病]