急性心肌梗死和不稳定性心绞痛患者粘附分子及相关因素的研究  

Study of adhesive molecule and related factors in patients with acute myocardial infarction and unstable angina pectoris

作　　者：田凤石[1] 李旸 胡大一[2] 姜霞[1] 孙华[1] 葛进[1] 赵明[1] 王培元[1] 王金良[1] 

机构地区：[1]天津市公安医院心内科,天津300050 [2]北京大学人民医院心内科,北京100044

出　　处：《中华老年心脑血管病杂志》2001年第5期301-304,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的　探讨急性心肌梗死 (AMI)和不稳定性心绞痛 (UAP)患者发病早期和 1周可溶性细胞间粘附分子 1(sICAM 1)、可溶性血管细胞粘附分子 1(sVCAM 1)、D 二聚体、血小板第 4因子 (PF4 )的动态变化及其相互关系。方法　测定 40例AMI、45例UAP患者发病 2 4h和 1周时血清sICAM 1、sVCAM 1、D 二聚体、PF4 并与 30例对照组比较。结果　AMI和UAP患者于发病 2 4h和 1周时sICAM 1、sVCAM 1、D 二聚体、PF4 均明显高于对照组 (P<0 0 1)。AMI组中 ,溶栓再通者与未溶栓者sICAM 1、sVCAM 1、D 二聚体、PF4 比较 ,差异无显著性意义 (P>0 0 5 )。AMI溶栓组中再通后与再通前相比 ,sICAM 1、sVCAM 1、D 二聚体均明显下降 (P <0 0 5 ) ;AMI、UAP组于发病 2 4h及 1周时sICAM 1与sVCAM 1均具有正相关性 (P <0 0 1) ,PF4 与sICAM 1、sVCAM 1、D 二聚体间亦具有正相关性 (P <0 0 1)。结论　AMI、UAP从发病早期至 1周sICAM 1、sVCAM 1持续升高 ,以AMI更为明显 。Objective To investigate the dynamic changes and correlations of soluble intercellular adhesion molecule 1(sICAM 1),soluble vascular cell adhesion molecule 1(sVCAM 1),D dimer(D D) and platelet factor 4(PF 4) in patients with acute myocardial infarction(AMI) and unstable angina pectoris(UAP).Methods The levels of serum sICAM 1,sVCAM 1,D D and PF 4 were measured in 40 patients with AMI,45 patients with UAP within 24 hours and one week after onset of the disease and 30 normal controls.Results The levels of sICAM 1,sVCAM 1,D D and PF 4 were higher in AMI and UAP group within 24 hours and one week after onset of the disease(P<0 01) than in control group and decreased in the AMI population after reperfusion.sICAM 1 had positive correlation with sVCAM 1 24 hours and one week after onset of the disease in AMI and UAP groups.PF 4 had positive correlation with sICAM 1,sVCAM 1 and D D(P<0 01),but D D had no correlation with sICAM 1 and sVCAM 1(P>0 05).Conclusion The levels of sICAM 1,sVCAM 1 increased continually from the onset to the end of the first week of the disease in the patients with acute coronary syndrome,especially in the patients with AMI,indicating that inflammation is involved in the process of injury of myocardial cells.

关 键 词：心肌梗塞 不稳定型心绞痛 细胞间粘着分子 AMI UAP 病理学 

分 类 号：R542.22[医药卫生—心血管疾病] R541.4[医药卫生—内科学]