老年急性冠状动脉综合征合并糖尿病患者血浆内皮微粒的变化  

Changes of Plasma Endothelial Microparticles in Elder Patients With Acute Coronary Syndrome Combining Diabetic Mellitus

作　　者：李妙男[1] 王洪巨[1] 赵皓[1] 黄宇理[1] 史晓俊[1] 王本芳[1] 

机构地区：[1]蚌埠医学院第一附属医院心血管内科,安徽省蚌埠市233000

出　　处：《中国循环杂志》2014年第8期570-573,共4页Chinese Circulation Journal

摘　　要：目的:探讨老年急性冠状动脉(冠脉)综合征(ACS)合并糖尿病患者血浆内皮微粒(EMP)水平及其与ACS合并糖尿病之间的相关性。方法:入选我院行冠脉造影检查且年龄≥65岁患者208例,男性124例,平均年龄(71.9±5.2)岁。208例患者分为三组:ACS合并糖尿病者为糖尿病组(n=74),ACS不合并糖尿病者为非糖尿病组(n=83),冠脉造影正常且不合并糖尿病者为对照组(n=51)。应用FACSCalibur型流式细胞仪检测血浆EMP水平,标记为CD31+/CD42b-EMPs,采用Gensini评分对每支血管病变狭窄程度进行定量计算。结果:血浆CD31+/CD42b-EMPs水平非糖尿病组较对照组、糖尿病组较非糖尿病组均升高,差异均有统计学意义(P<0.01)。糖尿病组多支血管病变者明显多于非糖尿病组,而单支血管病变者少于非糖尿病组,差异均有统计学意义(P<0.01)。糖尿病组和非糖尿病组患者Gensini评分值与血浆CD31+/CD42b-EMPs水平均呈正相关(r=0.637,P<0.01)。结论:老年ACS患者血浆EMP水平明显升高,且升高水平与冠脉病变程度及合并糖尿病有关,提示老年ACS患者血管内皮功能受损,合并糖尿病可加重内皮功能障碍。Objective： To explore the endothelial microparticle （EMP） level in elderly patients with acute coronary syndrome （ACS） combining diabetic mellitus （DM）） and to study the relationship between EMP level and ACS combining DM in elder patients. Methods： A total of 208 patients≥65 years with coronary angiography in our hospital were summarized including 124 male with the age of （71.9 ± 5.2） years. The patients were divided into 3 groups, Control group, n=51 normal subjects, ACS without DM group, n=83 and ACS＋DM group, n=74. Plasma EMP levels were measured by FACSCalibur lfow cytometry as CD31＋/CD42b-EMPS and the vascular stenosis degree was quantitatively calculated with Gensini score. Results： The CD31＋/CD42b-EMPs level in ACS ＋ DM group 〉ACS without DM group 〉 Control group, all P〈0.01. Compared with ACS without DM group, the ACS＋DM group had more patients with multiple vascular lesions and less patients with single vascular lesions, all P〈0.01. The Gensini score was positively related to CD31＋/CD42b-EMP level in both ACS＋DM group and ACS without DM group （r=0.637, P〈0.01）. Conclusion： Plasma CD31＋/CD42b-EMPs level increased in elderly ACS patients and the elevation level related to vascular lesion degree/combining with DM, which indicated the endothelial dysfunction in such patients.

关 键 词：老年患者 急性冠状动脉综合征 糖尿病 内皮微粒 

分 类 号：R541[医药卫生—心血管疾病]