ST段抬高型心肌梗死患者内皮微粒与心肌损伤的关系  

The relationship between endothelial microparticles in patients with ST- elevated myocardial infarction and myocardial injury

作　　者：秦光明[1] 金亚平[1] 杨旭峰[1] 蒋珍妮 

机构地区：[1]浙江大学医学院附属第二医院检验科,杭州310009 [2]心内科

出　　处：《中华急诊医学杂志》2012年第7期701-705,共5页Chinese Journal of Emergency Medicine

基　　金：浙江省卫生厅资助项目（20088096）;浙江省中医药管理局资助项目（2008CB038）

摘　　要：目的观察ST段抬高型心肌梗死患者外周血内皮微粒（CD31^＋／CD42b^-）的水平，探讨CD31^＋／CD42b^-内皮微粒与传统心肌损伤指标的相关性。方法随机选取2010年1月至2010年12月经冠状动脉造影证实的冠心病患者44例，其中稳定性心绞痛（SAP）患者22例，ST段抬高型心肌梗死患者22例；同期门诊体检健康的对照组22例进行前瞻性观察研究。应用流式细胞仪检测入院时外周血CD31^＋／CD42b^-内皮微粒的水平，应用生化分析仪检测肌酸激酶（CK）及其同工酶（CK-MB），高敏C反应蛋白（hs-CRP）等；用化学发光仪检测肌钙蛋白I（cTnI）。STEMI组每4h检测心肌损伤标志物直至入院后48h。分析入院时血CD31^＋／CD42b^-内皮微粒与心肌损伤标志物峰值的关系。结果STEMI患者外周血CD31^＋／CD42b^-内皮微粒的水平显著高于SAP组、正常对照组（P〈0．01），且SAP组与健康对照组比较差异无统计学意义（P〉0．05）。STEMI患者心肌损伤标志物（CK，CK-MB，cTnI和hs-CRP）与循环血CD31^＋／CD42b^-的Spearman相关性分析结果分别为：r=0．489，P=0．021；r=0．501，P=0．018；r=0．491，P=0．02；r=0．612，P=0．002。结论外周血CD31^＋／CD42b^-内皮微粒的水平有可能成为预测STEMI患者心肌损伤的指标。Objective To observe the level of circulatingCD31^＋/CD42b^-endothelial microparticles in patients with ST- elevated myocardial infarction （STEMI） , and discuss the correlation between CD31^＋/CD42b^- and traditional myocardial injury index. Methods A total of 22 healthy subjects and 44 patients with angiographically confirmed coronary atherosclerotic lesions collected from January 2010 to December 2010 were studied prospectively. The patients were divided into SAP （stable angina pectoris, Canadian Cardiovascular Society, CCS Ⅱ to Ⅲ ） group （n =22） and STEMI group （n =22）. The level of circulating CD31^＋/CD42b^-endothelial microparticles was detected by flow cytometric device after admission; creatine kinase （CK） and its isoenzymes （CK-MB） were detected by using biochemical analyzer; C-reactive protein was determined by a highly sensitive latex-enhanced turbidimetric immunoassay with a low detection limit of 0. 25 mg/dl （IMMAGE, Beckman Coulter; Reagent from Orion Diagn Co. Ltd., Vantaa, Finland）. Cardiac troponin I was measured by chemiluminescence immunoassay （ACCESS2 from Beckman Coulter）. In 22 STEMI patients, blood sample was taken not only after admission but subsequently at 4-hour intervals during the first 48 hours. Peak levels of myocardial enzymes after injury （creatine kinase, CK; creatine kinase MB isoenzyme, CK-MB; c troponins I, cTnl） and high sensitive C reactive protein （hs-CRP） values were determined. The correlation between circulating level of CD31^＋/CD42b^- and peak levels of myocardial biomarkers after injury were analyzed. Results The endothelial micro-particles were significantly higher inSTEMI patients than those in either SAP group or normal group （ P 〈 0. 01 ） , whereas there was no difference between the latter two groups. In STEMI patients studied in these cross sectional study, circulating CD31^＋/CD42b^-microparticles were positively correlated with peak level of myocardial biomarkers after injury. Moreover, the correlations be

关 键 词：心肌梗死 内皮微粒 心肌损伤 

分 类 号：R541.4[医药卫生—心血管疾病]