急性冠脉综合征患者循环免疫复合物及超敏C反应蛋白与斑块易损性关系研究  

Relationship between Circulating Immune Complexes and Vulnerable Plaque in Patients with Acute Coronary Syndrome

作　　者：蔡湘丽[1] 韩同亮[1] 李梅 宋达琳 王束玫[1] 康维强 

机构地区：[1]山东大学公共卫生学院,山东省济南市250012 [2]青岛市老年医学研究所

出　　处：《中国全科医学》2010年第21期2326-2328,共3页Chinese General Practice

基　　金：青岛市科技局(06-2-2-4-nsh)

摘　　要：目的探讨急性冠脉综合征(ACS)患者循环免疫复合物(CICs)及超敏C反应蛋白(hs-CRP)与冠状动脉斑块易损性的关系。方法 62例ACS患者采用酶联免疫吸附试验(ELISA)双抗体夹心法测定血浆CICs及hs-CRP,常规冠状动脉造影,并行血管内超声(IVUS)检测事件相关病变处斑块形态学及特征,分析急性心肌梗死(AMI)与不稳定性心绞痛(UAP)组患者、斑块破裂组与非斑块破裂组、易损斑块组与非易损斑块组CICs及hs-CRP的改变,以及CICs与斑块形态学指标的相关性。结果 AMI组CICs水平较UAP组明显升高,差异有统计学意义(P<0.05);斑块破裂组与非斑块破裂组CICs水平比较,差异有统计学意义(P<0.05);易损斑块组与稳定斑块组CICs水平比较,差异无统计学意义(P>0.05)。AMI组hs-CRP水平较UAP组明显升高,差异有统计学意义(P<0.05);斑块破裂组hs-CRP水平较非斑块破裂组明显升高,差异有统计学意义(P<0.05);易损斑块组hs-CRP水平较非易损斑块组明显升高,差异有统计学意义(P<0.05)。AMI组CICs水平与远端管腔面积(LCSA)呈负相关(P<0.05),在UAP组则呈正相关(P<0.05)。结论 CICs水平在AMI组及斑块破裂组明显升高,hs-CRP水平在AMI组、斑块破裂组及易损斑块组均明显升高,AMI组CICs水平越高LCSA越小,CICs的测定对于ACS患者冠状动脉内斑块破裂有重要的诊断意义。Objective To investigate the relationship between circulating immune complexes （CICs）/high sensitivity C-reactive protein （hs-CRP） and vulnerable plaque in the patients with acute coronary syndrome （ACS）.Methods A total of 62 patients with ACS were consecutively enrolled.Intravascular ultrasound （IVUS） was routinely performed.CICs and hs-CRP were determined by enzyme-linked immunosorbent assay （ELISA）,The changes of bio-factors were compared between vulnerable plaque and steady plaque groups,and between patients with acute myocardial infarction （AMI） and unstable angina （UA） patients,and between groups with plaque rupture and non-rupture.The relationship between the parameters of morphology and CICs were analyzed.Results CICs were significantly different between AMI group and UAP group（P0.05）.CICs was significantly increased in the plaque rupture group（P0.05）,while the levels of CICs had no significant difference between group of vulnerable and staple plaque groups （P0.05）.The level of hs-CRP was significantly higher in AMI Group than in UA group （P0.05）;also,it was significantly elevated in the plaque rupture group than in non-plaque rupture （P 0.05）.The vulnerable plaque group had significantly higher hs-CRP than in non-vulnerable plaque group （P0.05）.Furthermore,there were good correlation between CICs and lumen cross-sectional area （LCSA） （AMI P0.05;UAP P0.05）.Conclusion The levels of CICs are high in patients with AMI and non-plaque rupture,while hs-CRP concentrations are high in patients with AMI,plaque rupture,and vulnerable plaque.In patients with AMI,LCSA is smaller when CICs levels are high.The determination of CICs may be useful for predicting ACS and plaque rupture.

关 键 词：免疫复合物 冠状动脉斑块 心绞痛 不稳定型 心肌梗死 

分 类 号：R541.4[医药卫生—心血管疾病]