冠状动脉性心脏病患者外周血中CD144^＋／Annexin V^＋内皮微颗粒水平的变化  

Changes of CD144+/Annexin V+ endothelial microparticles in patients with coronary heart disease

作　　者：李莹[1] 夏金盈[1] 陆英 罗轶玮[1] 华奇峰[1] 顾宇英[1] 马岚[1] 张代富[1] 刘学波[1] 

机构地区：[1]同济大学附属东方医院心内科,上海200120 [2]中心实验室

出　　处：《上海医学》2012年第1期53-57,共5页Shanghai Medical Journal

基　　金：上海市科学技术委员会攻关项目(10411968000);上海市浦东新区优秀学科带头人培养计划(PWRd2007-02)资助

摘　　要：目的测定冠状动脉性心脏病患者外周血内皮微颗粒的水平,研究其与各种临床指标的相关性,探讨CD144+/Annexin V+内皮微颗粒与冠状动脉性心脏病患者发生急性缺血事件的关系。方法经冠状动脉造影确诊的冠状动脉性心脏病患者81例,根据临床症状、心电图及超敏肌钙蛋白结果将患者分为急性冠状动脉综合征组(A组,51例)和稳定型心绞痛组(B组,30例)。采用流式细胞术检测两组患者外周血中CD144+/Annexin V+的内皮微颗粒的水平,评估CD144+/Annexin V+内皮微颗粒与年龄、心率、血压、血脂、血糖、炎性指标、心肌标志物等各临床指标之间的相关性。结果与B组相比,A组的外周血CD144+/AnnexinV+内皮微颗粒的水平显著升高(P<0.01)。CD144+/Annexin V+内皮微颗粒的水平与脂蛋白a(r=0.886)、超敏C反应蛋白(r=0.404)、肌酸激酶同工酶(r=0.471)和超敏肌钙蛋白(r=0.240)均呈正相关(P值分别<0.01、0.05),与年龄、心率、收缩压、舒张压、脉压差、空腹血糖、餐后2h血糖、糖化血红蛋白、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇均不相关(P值均>0.05)。结论外周血CD144+/AnnexinV+内皮微颗粒的水平与脂蛋白a、超敏C反应蛋白、肌酸激酶同工酶、超敏肌钙蛋白有关,对于评价冠状动脉性心脏病高危状态具有较好的价值。Objective To investigate the levels of endothelial microparticles （EMPs） in the peripheral blood of patients with coronary heart disease （CHD） and its correlation with clinical parameters, and to explore the relationship between CD144^＋/Annexin V^＋EMPs and acute ischemic event in CHD patients. Methods Totally 81 CHD patients confirmed by coronary angiography were enrolled in this study. According to clinical symptoms,electrocardiogram （ECG） and high sensitivity troponin （hs-TnT）, they were divided into group A （acute coronary syndrome, n = 51 ） and group B （stable angina, n = 30）.CD144^＋/Annexin V^＋ EMPs in the peripheral blood were measured by flow cytometry. The correlations between the level of CD144^＋/Annexin V^＋ EMPs and various clinical parameters including age, heart rate, blood pressure, blood fat, blood glucose, inflammation markers, cardiacmarkers were evaluated. Results The level of CD144^＋/Annexin V^＋ EMPs was significantly higher in group A than that in group B （P〈0.01）. It was positively correlated with lipoprotein a （r = 0. 886, P = 0. 001）, high sensitivity C-reactive protein （ r = 0. 404, P = 0. 002）, creatine kinase isoenzyme （ r = 0.471, P 〈 0.001 ） and hsTnT （r = 0. 240, P = 0. 042）, and not correlated with age, heart rate, systolic pressure, diastolic pressure, pulse pressure, fasting glucose, postprandial glucose, glycosylated hemoglobin, total cholesterol, triglycerides, high density lipoprotein cholesterol or low density lipoprotein cholesterol （all P〉0.05）. Conclusion The level of CD144^＋/Annexin V^＋ EMPs in peripheral blood is correlated with lipoprotein a, high sensitivity C-reactive protein, creatine kinase isoenzyme and high sensitivity troponin, and is helpful for the evaluation of high risks in CHD patients. （Shanghai Med J, 2012, 35： 53-57）

关 键 词：内皮微颗粒 冠状动脉性心脏病 急性冠状动脉综合征 稳定型心绞痛 内皮功能 

分 类 号：R541.4[医药卫生—心血管疾病]