血管性血友病因子与急性冠脉综合征的相关性研究

目的探讨急性冠脉综合征患者血清中血管性血友病因子（von Willebrand factor，vWF）的变化规律和临床预后关系。方法选取经冠脉造影检查确诊急性冠脉综合征患者62例，按国际标准分为急性心肌梗死组、不稳定型心绞痛组，选取同期健康人30例作为对照组。患者入院后次日早8时抽取空腹静脉血来测定血清vWF含量，并且随访1～3年，观察急性冠脉综合征患者主要不良心脏事件的发生率。结果急性冠脉综合征患者血清中vWF水平明显高于对照组（P〈0．01），并随着vWF水平的升高，主要心脏不良事件的发生率明显递增（P〈0．05）；在多变量的Logistic回归分析中，vWF独立于年龄、性别、吸烟、高血压及糖尿病等危险因素，可预测急性冠脉综合征患者的患者主要不良心脏事件的发生率（P〈0．01）。结论血清中vWF水平有助于急性冠脉综合征患者的危险分层和预后的判断。

The Relationship Between von Willebrand Factor and Acute Coronary Syndrome

Objective To evaluate the change of plasma von Willebrand factor（vWF） and clinical prognosis in patients with acute coronary syndrome. Methods 62 patients with acute coronary syndrome based on coronary angiography were divided into unstable angina pecyoris group and acute myocardial infarction , 30 healthy volunteer served as control . All patients were measured the level of plasma vWF and followed up for 1 - 3 years . Results The plasma levels of vWF of patients with acute coronary syndrome higher than control group （ P 〈0.01 ） ,with the increased plasma levels of vWF , the rate of major adverse cardiac events was increased greatly （ P 〈 0.05 ） ; After multivariate Logistic regressive analysis , among these risk factors of age , sex ,smoke , hypertension , diabete ,et al. vWF was an independent risk factor, it predicted the occurrence rate of major adverse cardiac events in patients with acute coronary syndrome （P 〈 0.01 ）. Conclusion The plasma levels of vWF of patients with acute coronary syndrome contributes to risk stratification and predicator of prognosis.