急性冠状动脉综合征患者血浆尾加压素Ⅱ水平与冠状动脉斑块稳定程度的相关性研究  

Relationship Between Plasma Level of Urotensin Ⅱ and Stability of Coronary Atherosclerotic Plaque in Patients With Acute Coronary Syndrome

作　　者：郭丽娟[1,2] 尹春琳[1] 张燕莉[3] 王红霞[4] 刘雪[1] 李国楠[1] 夏经钢[1] 刘马超[1] 徐东[1] 

机构地区：[1]首都医科大学宣武医院心脏科,北京市100053 [2]北京大学国际医院心内科 [3]首都医科大学宣武医院神经生物室,北京市100053 [4]首都医科大学病理生理学教研室

出　　处：《中国循环杂志》2015年第10期958-961,共4页Chinese Circulation Journal

基　　金：首都医科大学基础-临床科研合作基金(13JL-L06)

摘　　要：目的:观察研究急性冠状动脉综合征(ACS)患者血浆尾加压素Ⅱ(UⅡ)水平及动态变化与冠状动脉(冠脉)斑块稳定程度的相关性。方法:连续入选2013-03至2013-08在我院心脏内科住院的ACS患者135例。健康对照者48例。测定ACS患者入院即刻血浆UⅡ、高敏C反应蛋白(hs-CRP)、N末端B型利钠肽原(NT-proBNP)水平。随访的58例ACS患者3个月门诊随访时测定UⅡ水平。结果:ACS患者入院即刻血浆UⅡ水平较健康对照者显著升高[(39.82±22.28)pg/ml vs(26.88±6.09)pg/ml,P<0.001];ST段抬高型心肌梗死(STEMI)患者入院即刻血浆UⅡ水平显著低于非ST段抬高型心肌梗死(NSTEMI)患者[(37.41±22.74)pg/ml vs(48.07±15.82)pg/ml,t=2.092,P<0.05]。ACS患者入院即刻血浆UⅡ水平与hs-CRP(r=0.041,P=0.639)、NT-proBNP(r=0.112,P=0.261)无相关关系。3个月时门诊随访的58例急性心肌梗死患者,血浆UⅡ水平为(56.52±20.70)pg/ml,较入院时(51.58±18.70)pg/ml显著增加,差异有统计学意义(t=-2.366,P<0.05)。结论:不同临床类型的ACS患者入院即刻血浆UⅡ水平存在差别,从不稳定型心绞痛(UAP)到NSTEMI再到STEMI呈递减趋势,STEMI显著低于NSTEMI,随病情的稳定,ACS患者的血浆UⅡ水平呈显著升高趋势,入院即刻血浆UⅡ水平与炎性标记物hs-CRP和心室负荷标记物NT-proBNP不相关,冠心病患者血浆UⅡ水平不仅与动脉粥样硬化的程度,同时可能与动脉粥样硬化的性质或稳定性相关。Objective： To observe the relationship between the dynamic changes of plasma levels of urotensin II （UII） and the stability of coronary atherosclerotic plaque in patients with acute coronary syndrome （ACS）. Methods： Our research included 2 groups： ACS group, n=135 consecutive patients treated in our hospital from 2013-03 to 2013-08 that including unstable angina pectoris （UAP） sub-group, n=7, non-ST segment elevation myocardial infarction （NSTEMI） sub-group, n=22 and STEMI sub-group, n=106. In addition, there was a Control group, n=48 healthy subjects. Plasma levels of UII, hs-CRP and NT-proBNP were examined and compared among different groups at different time points. Results： Compared with Control group at immediate admission, ACS group had increased plasma level of UII （39.82±22.28） pg/ml vs （26.88± 6.09） pg/ml, P〈0.001; UII level in STEMI sub-group was lower than NSTEMI sub-group （37.41± 22.74） pg/ml vs （48.07 ±15.82） pg/ml, t=-2.092, P 〈0.05. In ACS patients, UII had no correlation to hs-CRP （r=0.041, P=0.639） and NT-proBNP （r=0.112, P=0.261） at immediate admission. There were 58 ACS patients finished the 3 months follow-up study and their UII level was increased than immediate admission as （56.52 ± 20.70） pg/ml vs （51.58±18.70） pg/ml, t=-2.366, P〈0.05. Conclusion： Plasma levels of UII have been changing in different type of ACS patients at immediate admission, UII presented decreasing trend from UAP to NSTEMI to STEMI, while it had increasing trend upon stabilized condition; the admission level of UII had no correlation to inflammatory marker hs-CRP and ventricular overload marker NT-proBNP. UII is not only related to the extent of atherosclerosis, but also related to the nature of atherosclerosis or the stability of plaques.

关 键 词：急性冠状动脉综合征 血浆尾加压素Ⅱ水平 斑块稳定性 

分 类 号：R54[医药卫生—心血管疾病]