【作者】 曹慧丽；

【导师】 申晓彧；

【作者基本信息】 山西医科大学 ， 心血管内科学， 2010， 硕士

【摘要】 目的研究急性冠脉综合征患者血浆抵抗素(Resistin)与P-选择素(P-selectin)的水平,分析二者的相关性,评价抵抗素和P-选择素在急性冠脉综合征发生发展中意义。方法选择经冠脉造影证实的102例急性冠脉综合征(acute coro-nary syndrome, ACS)患者,其中急性心肌梗死(acute myocardial infarction, AMI)50例,不稳定性心绞痛(unstable angina Pectoris, UAP)52例；拟诊冠心病冠脉造影正常的对照组(normal Control,NC)40例。酶联免疫吸附法(ELISA)测定血浆抵抗素和P-选择素水平,同时由我院检验中心统一检测血脂。结果1.急性冠脉综合征患者血浆抵抗素明显高于对照组[(4.09±0.78)ng/ml比(3.17±0.35)ng/ml p<0.05],其中急性心肌梗死组明显高于不稳定心绞痛组[(4.49±0.76)ng/ml比(3.70±0.59)ng/ml p<0.05]。2.急性冠脉综合征患者血浆P-选择素明显高于对照组[(129.97±6.72)ng／ml比(80.42±4.75)ng/ml p<0.05],其中急性心肌梗死组明显高于不稳定心绞痛组[(133.77±6.55)ng/ml比(126.31±4.56)ng／ml p<0.05]。3.抵抗素与甘油三酯呈正相关(r=0.28 p<0.05),与高密度脂蛋白胆固醇呈负相关(r=-0.45 p<0.05)。4.抵抗素与P-选择素呈正相关(r=0.43 p<0.05)。结论1.急性冠脉综合征组血浆抵抗素高于对照组,其中急性心肌梗死组较不稳定心绞痛组抵抗素水平明显增高,提示抵抗素在急性冠脉综合征的发生和发展过程起到重要作用。2.急性冠脉综合征组血浆P-选择素水平显著高于对照组,提示急性冠脉综合征患者可能存在血管内皮细胞的功能障碍和血小板高活性状态。其中P-选择素在急性心肌梗死组明显高于不稳定心绞痛组,提示急性心肌梗死较不稳定心绞痛血小板活化程度更重。3.抵抗素与甘油三酯呈正相关,与高密度脂蛋白胆固醇呈负相关,提示可能抵抗素通过引起血脂异常参与冠心病的发生发展。4.急性冠脉综合征患者血浆抵抗素和P-选择素正相关,提示血浆抵抗素浓度增加伴随P-选择素水平上升,两者可能共同在急性冠脉综合征的发生发展中发挥作用。更多还原

【Abstract】 ObjectiveTo investigate the changes of plasma resistin and P-selectin levels and study on the corelationship between resistin level and P-selectin level in patients with acute coronary syndrome(ACS). Methods102 patients with ACS were proved by coronary angiograph, including 50 acute myocardial infarction(AMI) cases and 52 unstable angina Pectoris(UAP)cases,40 patients with dubious coronary heart disease (CHD) but proved by coronary angiograph to be normal were selected as control cases. The method of ELISA was used to determine the plasma resistin and P-selectin levels. total cholesterol (TC), triglycerides(TG) were investigated by enzyme reagent method, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) were investigated by direct method in the unified test center of the second hospital of Shanxi medical university.Results1.The plasma resistin level in ACS group was significantly higher than that in control group[(4.09±0.78)ng/ml vs (3.17±0.35)ng/ml P<0.05J and the plasma resistin level in AMI group was significantly higher than that in UAP group[(4.49±0.76)ng/ml vs (3.70±0.59)ng/ml P＜0.05].2.The plasma P-selectin level in ACS patients was significantly higher than that in control group [(129.97±6.72)ng/ml vs (80.42±4.75)ng/ml P＜0.05] and the plasma P-selectin level in AMI group was significantly higher than that in UAP group[(133.77±6.55)ng/ml vs (126.31±4.56)ng/ml P<0.05].3.The plasma resistin level was positively correlated with TG(r=0.28 P<0.05),negatively correlated with HDL(r=-0.45 P<0.05).4.The plasma resistin level was positively correlated with P-selectin(r=0.43 P<0.05).ConclusionLACS patients have increased plasma resistin levels. plasma resistin levels was significantly higher in AMI group than in UAP group.suggesting that resistin in the occurrence and development of ACS has played an important role.2.ACS patients have increased plasma P-selectin levels, suggesting that endothelial cell dysfunction and platelet high activity state. P-selectin in AMI group was significantly higher than UAP group which indicates that AMI patients may have heavier degree of platelet activation than that in UAP patients.3.plasma resistin levels was positively correlated with TG，and HDL were negatively correlated, suggesting that the resistin involved in CHD by causing the development of dyslipidemia.4.plasma resistin levels in patients with ACS was positively correlated with P-selectin, suggesting that plasma resistin levels increased with P-selectin levels in patients with ACS, both common may play a role in the occurrence and development of ACS.更多还原