血浆可溶性受体酪氨酸激酶Mer和Tyro3与急性冠脉综合征的相关性研究  

The relationship between plasma soluble receptor tyrosine kinase Met/Tyro3 and acute coronary syndrome

作　　者：吴俊[1] Dahlback Bjorn 马玉良[3] 赵洁[4] 宋英[4] 陆松松[4] 赵京忠[4] 赵磊[4] 刘宁[4] 

机构地区：[1]北京积水潭医院检验科,100035 [2]瑞典隆德大学临床化学系瓦伦堡实验室 [3]北京大学人民医院心脏中心 [4]北京大学人民医院检验科

出　　处：《中华检验医学杂志》2013年第12期1126-1130,共5页Chinese Journal of Laboratory Medicine

基　　金：教育部博士点基金资助项目（20110001120088）

摘　　要：目的调查急性冠脉综合征（ACS）患者血浆生长抑制特异性蛋白6（Gas6）系统可溶性受体Axl、Mer和Tvr03的浓度，在实施冠状动脉介入手术（PCI）后的变化。方法病例对照研究。收集2011年至2012年，北京大学人民医院心脏中心66例急性冠脉综合征患者为ACS组[平均年龄（63．54-14．5）岁，男40例，女26例]，42例稳定型冠状动脉性心脏病患者为对照组[平均年龄（60．8±18．3）岁，男23例，女19例]。ACS患者在PCI术前及PCI后1h、4h、24h采集柠檬酸钠抗凝全血，稳定型冠状动脉性心脏病患者于门诊采血。分离血浆，ELISA试剂盒检测ACS患者血浆Gas6，可溶性受体Axl（sAx1）、可溶性受体Mer（sMer）、可溶性受体Tyr03（sTyr03）。ELISA试剂盒检测凝血酶抗凝血酶复合物（TAT）。ACS组与对照组数据比较，分析它们和临床生化指标及TAT的相关性。相关性分析采用Spearman’Srank相关性检验，组间差别性检验使用Mann—WhitneyU检验。结果ACS组sMer（中位数28．02μg/L，95％CI14．48—60．47）高于对照组（中位数14．91μg/L，95％ vs 7．87～25．86），U=42．5，P〈0．05。ACS组sTyr03（中位数16．91μg/L，95％CI5．81～28．52）高于对照组（中位数9．53μg/L，95％C14．17～24．56），U=127．0，P〈0．05。PCI术后1～24h其浓度变化无统计学意义，P值均〉0．05。sMer的浓度和凝血酶生成指标（TAT）相关（r=0．9218，P=0．014）。结论ACS患者血浆存在高水平可溶性受体酪氨酸激酶sMer和sTyr03，其浓度于PCI术后24h变化无统计学意义。Objective To investigate the concentrations of plasma Gas6 and its receptor in acute coronary syndrome patients and their dynamic changes after PCI. Methods In this case control study, we enrolled 66 ACS patients [ （ 63.5 ±14. 5 ） years age, 40 males and 26 females ] and 42 age and gender matched stable coronary heart disease patients as control group [ （ 60. 8 ± 18.3 ） years age, 23 males, 19 females]. All patients came from cardiovascular center of People＇s hospital, Peking University. Blood samples were collected before PCI and 1 h, 4 h, 24 h after PCI in ACS group. The plasma Gas6, sAxl, sMer, sTyro3, thrombin-antithrombin complex（TAT） concentrations were tested by ELISA kits. Data were compared by Mann-Whitney U test beteween the two groups. Their correlation with clinical indices and TAT were analyzed by. Spearman＇s rank correlation test. Results Both the concentrantions of sMer and sTyro3 were significantly higher in ACS groups than those in the control group. （ sMer ： median 28.02μg/L,95% CI 14.48 -60.47 vs. median 14. 91 μg/L, 95% CI 7.87 - 25.86, U = 42. 5, P 〈 0. 001 ; sTyro3 ： median 16.91μg/L, 95%C15.81 -28.52 vs. median 9.53μg/L, 95%CI4.17 -24.56, U= 127.0, P= 0. 001 ）. The changes of their concentration 24 h after PCI were not significant. The concentration of sMer iscorrelate strongly to thrombin-antithrombin complex （r = 0. 9218, P = 0. 014）. Conclusion The sMer and sTyro3 concentration are significant higher in ACS patients, their changes 24 h after PCI are not significant.

关 键 词：急性冠状动脉综合征 受体蛋白质酪氨酸激酶类 胞间信号肽类和蛋白质类 凝血酶 

分 类 号：R541.4[医药卫生—心血管疾病]