急性冠脉综合征与血管内皮生长因子及同型半胱氨酸的相关分析

目的：探讨急性冠脉综合征（ACS）患者血清同型半胱氨酸（HCY）及血管内皮生长因子（VEGF）浓度的变化及与冠状动脉狭窄程度的相关性。方法对入组的157例ACS患者依据症状、心肌酶及心电图变化分为ST 段抬高心肌梗死组（STE‐MI）、非ST段抬高心肌梗死组（NSTEMI）和不稳定型心绞痛组（UA）。依据冠状动脉造影检查将患者分为轻度狭窄病变组、中度狭窄病变组及重度狭窄病变组；同时采用酶联免疫吸附试验（ELISA）检测ACS患者的血清VEGF浓度的变化，采用循环酶法在贝克曼BXC800生化分析仪上测定HCY浓度。比较不同组之间VEGF及HCY浓度的差异。结果轻度狭窄病变组、中度狭窄病变组及重度狭窄病变组之间比较，VEGF差异有统计学意义（F＝39．9，P＝0．00）；UA组患者与NSTEMI组及STEMI组患者比较VEGF差异均有统计学意义（F＝123．3，P＝0．00）。重度狭窄病变组与轻度狭窄病变组及中度狭窄病变组比较 HCY差异均有统计学意义（F＝39．7，P＝0．00）；UA组、NSTEMI组及STEMI组比较 HCY差异均有统计学意义（F＝102．65，P＝0．00）。轻度狭窄病变组、不同程度冠状动脉狭窄组及不同临床诊断组患者血清VEGF及HCY浓度与Gensini积分呈正相关（r＝0．723，0．716）。结论 ACS患者血清VEGF、HCY浓度与冠状动脉病变程度及心肌坏死程度相关，并与Gensini积分相关。

Analysis on correlation between acute coronary syndrome with plasma level of vascular endothelial growth factor and homocysteine

Objective To investigate the correlation between the level change of serum homocysteine (HCY) and vascular endothelial growth factor (VEGF) with the degree of the coronary artery stenosis in the patients with acute coronary syndrome (ACS) .Methods A total of 157 ACS patients were divided into the ST‐elevation myocardial infarction (STEMI) group ,non‐ST el‐evation myocardial infarction (NSTEMI) group and unstable angina pectoris(UA) group based on the symptoms ,cardiac enzymes level and electrocardiogram changes .The cases were induded into the mild ,moderate and severe stenosis lesion groups according to the coronary arteriography examination;meanwhile the enzyme‐linked immunosorbent assay (ELISA) was used to detect the change of the serum VEGF concentration .The HCY level was determined by enzymatic cycling methods with the biochemical analyzer (BXC800 ,Beckman ,USA) .The differences in the concentrations of VEGF and HCY compared among different groups .Results The VEGF level had statistical differences among the mild ,moderate and sever stenosis groups(F=39 .9 ,P=0 .00) ,and between the UA group with the NSTEMI group and STEMI group(F=123 .3 ,P=0 .00) .The HCY level had statistically significant differ‐ence between the severe stenosis group with the mild and moderate stenosis groups (F=39 .7 ,P=0 .00);the HCY level had statis‐tically significant difference among the UA group ,NSTEMI group and STEMI group(F=102 .65 ,P=0 .00) .The VEGF and HCY levels in the mild stenosis group ,different degrees of coronary stenosis groups and different clinical diagnosis groups were positively correlated with the Gensini scores(r=0 .723 ,0 .716) .Conclusion The serum VEGF and HCY levels are correlated with the degree of the coronary artery lesion and myocardial necrosis in ACS patients ,furthermore are related with the Gensini scores .