应用阿司匹林的ACS患者血清COX-2和TXA-2改变的临床意义研究  

Clinical reseach on COX-2 and TXA-2 in serum of the patients with ACS who took aspirin

作　　者：温玉新[1] 

机构地区：[1]北华大学,吉林吉林130012

出　　处：《中国实验诊断学》2012年第11期2052-2054,共3页Chinese Journal of Laboratory Diagnosis

摘　　要：目的通过对服用阿司匹林的AMI、UAP、SAP患者和正常健康人血清中COX-2及TXA-2的浓度测定,探讨COX-2及TXA-2和服用阿司匹林的ACS的关系及其联合应用在应用阿司匹林的病人预防ACS出现的相关性临床研究。方法选择2004年10月到2009年2月在北华大学附属医院循环内科的住院患者74例。分为:急性心梗(AMI)组18例,不稳定型心绞痛(UAP)组33例,稳定型心绞痛(SAP)组25例,并设正常对照组36例。应用酶联免疫吸附法(ELISA)测定血清COX-2及TXA-2水平。结果 AMI组和UAP组患者血清COX-2水平显著高于SAP组和正常对照组(P<0.01),而AMI组COX-2略高于UAP组,但无统计学意义(P>0.05),SAP组COX-2略高于正常对照组,但也无统计学意义(P>0.05)。各组MMP-9水平,AMI组与UAP组明显高于SAP组,差异显著(P<0.05),而AMI组略高于TXA-2组,但无统计学意义(P>0.05),SAP组TXA-2略高于正常对照组,但也无统计学意义(P>0.05)。为了探讨血清COX-2及TXA-2的关系,对AMI组和UAP组COX-2及TXA-2水平进行相关性分析,结果发现二者显著正相关(r=0.491 8,P<0.01),而SAP组和正常对照组无明显相关性。结论本研究发现AMI组和UAP组外周血COX-2及TXA-2水平较SAP组和正常对照组明显升高,提示COX-2及TXA-2可能与急性冠脉综合征的发病有关,可能是阿司匹林抵抗所致动脉粥样斑块不稳定的标志,对于急性冠脉综合征患者的病情判断以及预后具有一定程度的意义。AMI组和UAP组患者外周血COX-2水平与外周血TXA-2水平呈显著正相关。提示TXA-2可能是通过促进COX-2的表达而促发血栓事件。Objective To probing into the relationship and clinical sense research between COX-2 and TXA-2 and acute coronary syndrome with taking aspirin by detecting serum of patients in team AMI、UAP、SAP and healthy control team.Methods 74 patients can be selected who were treated in coronary ward in Beihua university affiliated hospital from 10,2004 to 2,2009.Subjects can be divided into acute miocardial infarction team（AMI） with 18 patients and unstable angina pectoris team（UAP） with 33 patients and stable angina stable team（SAP） with 25 patients and healthy control team with 36 patients to detecting levels of COX-2 and TXA-2 by ELISA.Results Compared with SAP and healthy control team,COX-2 in serum is higher than AMI and UAP,the gap is more evident（P0.01）.Compared with healthy control team,COX-2 in serum is a little higher than SAP,the gap is not evident（P0.05）.Compared with SAP and healthy control team,TXA-2 in serum is higher than AMI and UAP,the gap is more evident（P0.01）.Compared with healthy control team,TXA-2 in serum is a little higher than SAP,the gap is not evident（P0.05）.Conclusion From the research,we can find that compared with SAP and healthy control team,COX-2 and TXA-2 in serum is higher than AMI and UAP,that demonstrates that COX-2 and TXA-2 had something with acute coronary syndrome after taking aspirin.It is likely a symbol of unstable atherosclerotic plaque in AR.There is some sense in judging state of an illness and prognosis of the patients with acute coronary syndrome.The level of COX-2 in serum of AMI is positive relative to UAP,hat demonstrates that COX-2 can promote thrombus affair through arousing expression of TXA-2.

关 键 词：阿司匹林抵抗 急性冠脉综合征 COX-2 TXA-2 

分 类 号：R541.4[医药卫生—心血管疾病]