冠心病患者外周血RANTES、PAI-1和ADMA水平的变化及与GRACE评分的相关性分析  

Serum levels of RANTES,PAI-1,ADMA in patients with coronary heart disease and correlation with GRACE risk score

作　　者：李琳[1] 李芳[1] 肖婷[1] 李妍[1] 曾欧[1] 褚春[2] 文格波[3] 杨军[1] 

机构地区：[1]南华大学附属第一医院心血管内科,湖南衡阳421001 [2]南华大学附属第二医院药剂科,湖南衡阳421001 [3]南华大学附属第一医院内分泌科,湖南衡阳421001

出　　处：《临床检验杂志》2015年第8期577-580,共4页Chinese Journal of Clinical Laboratory Science

基　　金：国家自然科学基金(81270181;81202830)

摘　　要：目的观察不同类型冠心病患者外周血活化T细胞趋化因子(RANTES)、血浆纤溶酶原激活物抑制剂-1(PAI-1)、非对称性二甲基精氨酸(ADMA)水平的变化,探讨其与冠心病GRACE评分的关系。方法选择行冠状动脉造影术的住院患者150例,其中无症状心肌缺血(SMI)组28例,稳定型心绞痛(SAP)组59例,急性冠脉综合征(ACS)组63例。用ELISA法测定血清RANTES、PAI-1和ADMA水平,并计算患者GRACE评分,分析RANTES、PAI-1和ADMA水平与GRACE危险分层的关系。结果 ACS组外周血RANTES、PAI-1、ADMA水平均高于SMI组和SAP组,差异有统计学意义(P<0.05);SAP组和SMI组RANTES、PAI-1、ADMA水平间比较,差异均无统计学意义(P>0.05)。外周血RANTES与PAI-1、ADMA水平均呈正相关(r=0.334,P=0.000;r=0.173,P=0.021),而血清PAI-1与ADMA水平无明显相关性,血清RANTES、PAI-1、ADMA水平与患者GRACE评分均未显示出明显相关性。结论 GRACE评分联合检测外周血RANTES、PAI-1和ADMA水平,可能有助于冠心病患者危险分层,能更有效地预测急性冠脉事件的发生。Objective To observe the differences of regulated upon activation normal T cell expressed and secreted factor（ RANTES）,plasminogen activator inhibitor 1（ PAI-1） and asymmetric dimethylarginine（ ADMA） levels in peripheral blood of the patients with different subtype of coronary heart disease（ CHD）,and explore the correlation between the serum levels of RANTES,PAI-1,ADMA and GRACE risk score. Methods A total of 150 cases of hospitalized patients with coronary artery angiography were enrolled,including28 cases of silent myocardial ischemia（ SMI） group,59 cases of stable angina pectoris（ SAP） group and 63 cases of acute coronary syndrome（ ACS） group. The levels of RANTES,PAI-1 and ADMA were measured by ELISA. GRACE risk score of the patients were calculated and the correlations between the levels of RANTES,PAI-1 and ADMA and GRACE risk score were analyzed. Result The level of RANTES,PAI-1 and ADMA of ACS group were significantly higher than those of SAP group and SMI group（ P 0. 05）. The levels of RANTES,PAI-1 and ADMA between SAP and SMI group did not show significant difference（ P 0. 05）. Positive correlations between the levels of RANTES and PAI-1（ r = 0. 334,P = 0. 000） and ADMA（ r = 0. 173,P = 0. 021） were found,but no positive correlation was shown between the levels of PAI-1 and ADMA. Also,no correlation was shown between the levels of RANTES,PAI-1and ADMA and GRACE risk score. Conclusion GRACE score combined the detections of RANTES,PAI-1 and ADMA levels in peripheral blood could be more beneficial for stratification of coronary heart disease risk and more effectively predict the occurrence of acute coronary events.

关 键 词：冠心病 活化T细胞趋化因子 血浆纤溶酶原激活物抑制剂-1 非对称性二甲基精氨酸 危险分层 

分 类 号：R541.4[医药卫生—心血管疾病]