可溶性血栓调节蛋白在急性冠脉综合征中的临床意义

目的 测定急性冠脉综合征(ACS)患者可溶性血栓调节蛋白(sTM)水平并探讨其临床意义.方法 用ELISA法测定48例ACS患者(ACS组)及10例对照者(对照组)sTM水平,并对冠状动脉造影结果、各种冠心病危险因子和主要心脏不良事件与sTM水平之间的关系进行统计分析.结果 ACS组sTM水平高于对照组[(3.674±71)μg/L比(2.34±0.43)μg/L,P<0.05].危险因子数>2个患者的sTM水平高于危险因子数≤2个患者[(4.93±2.76)μg/L比(3.13±0.81)μg/L,P<0.05];病变血管数>2支患者的sTM水平高于病变血管数≤2支患者[(4.60±2.83)μg/L比(2.91±0.23)μg/L,P<0.05].sTM>3.2 μg/L患者的主要心脏不良事件发生率显著高于sTM≤3.2 μg/L患者(70.0%比35.7%,P<0.05).结论 sTM水平是反映内皮细胞损伤程度和范围的良好标志,它与冠心病危险因子的损伤作用有关,并对ACS的病变范围和预后有提示意义.

The clinical significance of soluble thrombomodulin in acute coronary syndrome

Objective To study the levels of soluble thrombomodulin (sTM)in patients with acute coronary syndrome (ACS) and evaluate its clinical significance. Method Measured the sTM levels with enzyme linked immunosorbent assay, and described the characteristics of coronary arteriography, risk factors of coronary heart disease, and adverse events in a case-control study of 48 ACS patients (ACS group)and 10 normal people (control group). Results The level of sTM in ACS group was (3.67±1.71) μg/L, and (2.34±0.43)μg/L in control group (P<0.05). The level of sTM in the patients of risk factors or impaired vessels number more than 2 increased significantly than those in the patients of risk factors or impaired vessols number inferior or equal to 2, (4.93±2.76) μg/Lvs (3.13±0.81) μg/L, P<0.05, (4.60± 2.83) μg/L vs (2.91±0.23) μg/L, P < 0.05 respectively. The incidence of cardiac events in the patients of sTM more than 3.2 μg/L (70.0%)was higher significantly than that in the patients of sTM inferior or equal to 3.2 μg/L(35.7%), P< 0.05. Conclusions The levels of sTM are valuable markers to evaluate the impaired degree and scope of endothelial cells in ACS. They are also associated with the number of risk factors, and useful in predicting the extent and prognosis of the disease.