冠心病患者循环内皮细胞微颗粒和hs-CRP的变化及临床意义

【中图分类号】R524 【文献标识码】B 【文章编号】1672－3783(2011)11－0003－01

【关键词】冠心病 内皮细胞微颗粒（EMPs） hs-CRP 冠状动脉造影(CAG) 急性心肌梗死（AMI）

【Key words】Coronary heart disease;Endothelial microparticles;High sensitivity C-reactive protein;coronary angiography;Acute myocardial infartion.

目的

通过研究冠心病患者循环内皮细胞微颗粒（CD62E（+）EMPs）及血浆高敏C反应蛋白（hs-crp）的含量变化及其相关性，探讨急性冠脉综合征、动脉粥样硬化发生与炎症及内皮功能的关系。

方法

根据临床诊断和冠状动脉造影结果将79例患者分为急性心肌梗死组（AMI）25例，不稳定性心绞痛组（UA）28例，和正常对照组（26例），采用流式细胞仪测量CD62E（+）EMPs，全自动生化分析仪行免疫比浊法测定hs-CRP。

结果

AMI组、UA组和正常组三组CD62E(+)EMPs水平分别为439.24±145.24个/ul、367.01±135.30个/ul、324.08±124.43个/ul。较正常对照组，急性心肌梗死患者循环CD62E(+)EMPs水平明显升高（P=0.003），而急性心肌梗死组与心绞痛组、心绞痛组与正常对照组之间循环CD62E(+)EMPs无差异(p>0.05)；CD62E(+)EMPs计数与hs-CRP之间存的相关性（p

结论

1 急性心肌梗死患者血浆CD62E（+）EMPs和hs-CRP水平明显高于对照组，二者是预测ACS的重要指标。

2 血浆CD62E（+）EMPs和hs-CRP水平在ACS患者中升高，二者呈正相关，说明冠心病不稳定状态与内皮细胞活化、炎症反应相关。

【Objectives】he aim of this study was to analysis the value of serum level of endothelial microparticles (EMPs) in patients with coronary artery disease(CAD).To detect the relationship between C-reactive protein and EMPs and the severity of coronary artery disease.

【Methods】A prospective,case-controlled study was conducted on 53patients with CAD and 26 control subjects to investigate EMPs profiles.Included were 25 patients with acute myocardial infarction（AMI）and 28 with unstable angina(UA).EMPs in platelet-poor plasma were measured flow cytometrically with combinations of fluorescent antibodies(anti-CD62E),hs-CRP were measured.

【Results】The serum CD62E(+) EMPs concentrations were 324.08±124.43count/、367.01±135.30count/ul、439.24±145.24count/ul,respectively,for the normal control group,the UA group and the AMI group.The CD62E(+) EMPs level was significantly higher in patients with AMI than in control subjects(P

【Conclusions】 (1) The serum hs-CRP and CD62(+)EMPs levels were significantly high in patients with AMI,They are important markers in predicting ACS. (2) EC activation is associated with the inflammatory response,Endothelial cell(EC) activation and inflammatory play a role in the pathophysiology of ACS.

作者单位 苏州市中医医院心血管内科1

苏州大学附属第一医院心血管内科2