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变异性心绞痛患者血管内皮功能相关指标测定的临床意义
引用本文:花纯宏,余文辉,孙振亚,周小梅,陈芸,曲敬来. 变异性心绞痛患者血管内皮功能相关指标测定的临床意义[J]. 邯郸医学高等专科学校学报, 2006, 0(1)
作者姓名:花纯宏  余文辉  孙振亚  周小梅  陈芸  曲敬来
作者单位:广东省深圳市中医院检验科,广东省深圳市中医院检验科,广东省深圳市宝安西乡人民医院,广东省深圳市中医院检验科,广东省深圳市中医院检验科,广东省深圳市中医院检验科 518102,518102,518102,518102,518102
摘    要:目的研究变异性心绞痛(VAP)患者血管内皮功能相关指标的变化。方法征集疑为冠状动脉性心脏病(CAD)或电生理研究提示心律失常而行诊断性心导管术的住院患者共93例,根据相关诊断标准将其分为3组,其中 VAP 患者39例,劳力性心绞痛(EAP)患者35例,对照组19例。根据临床症状的严重度,将 VAP组再分为轻度 VAP 组22例和重度 VAP 组17例。采集血样分别测定各组患者的白细胞(WBC)及分类计数、血浆纤维蛋白原(Fbg)、内皮素(ET-1)、血管性血友病因子(vWF)、C-反应蛋白(CRP)以及冠心病(CHD)其他危险因子,如总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)等的变化。结果除 EAP 组高密度脂蛋白胆固醇(HDL-C)明显低于对照组外(P<0.01)。其他CHD 危险因子、体温、WBC 总数、CRP 等在 VAP、EAP 及对照组间差异无显著性意义(P>0.05)。而重度 VAP组 EOS 明显高于其他三组(P<0.01)。重度 VAP 组血浆 Fbg、ET-1和 vWF 也明显高于其他3组(P<0.05)。VAP 患者经药物治疗后,EOS 计数、血浆 Fbg、ET-1和 vWF 明显低于对照组(P<0.01)。结论 EOS 计数和血浆 Fbg,ET-1和 vWF 水平可预示 VAP 病情严重度,提示冠状动脉痉挛可能引起 EOS 和 Fbg、ET-1和 vWF 水平升高。

关 键 词:变异性心绞痛  嗜酸性粒细胞  纤维蛋白原  内皮素  血管性血友病因子

Clinical Signification of Determination of Vascular Endothelium Function Markers in Patients with Variant Angina Pectoris.
HUA Chun-hong YU Wen-hui SUN Zhenya. Clinical Signification of Determination of Vascular Endothelium Function Markers in Patients with Variant Angina Pectoris.[J]. Journal of Handan Medical College, 2006, 0(1)
Authors:HUA Chun-hong YU Wen-hui SUN Zhenya
Affiliation:HUA Chun-hong YU Wen-hui SUN Zhenya.Department of experiment diagnosis,Shenzhen Hospital of Traditional Chinese Medicine,Shenzhen 518033,China
Abstract:Objective To investigate the clinical signification of determination of vascular endothehum function markers in patients with variant angina pectoris(VAP).Methods All subjects(n=93)were elected from patients who were hospi- talized for diagnostic catheterization because of suspected corenary artery disease or for the electrophysiologic study of arrhyth- mia.The patients were divided into 3 groups according to the criteria of diagnosis.The VAP group(n=39)who had sponta- neous angina attacks,the stable angina pectoris(EAP)group(n=35)and control group(n=19).Patients with VAP were further divided into mild VAP(n=22)and severe VAP(n=17)based on the severity of symptoms.Fasting vein blood were collected for differential and white blood ceils(WBC)counts,fibrinogen(Fbg),endothelin-1(ET-1),yon willebrand factor (vWF) and C-reactive protein(CRP),and other risk factors of coronary heart disease(CHD)such as total Choles- terel(TC),triglyceride(TG),high density lipoprotein-Cholesterol(HDL-C)and low density lipopretein-Cholesterol (LDL-C),et al.Results There were no significant differences among the control,VAP,EAP groups,except for the HDL-C levels in the EAP group were significantly lower than those in the control group(P<0.01).In addition,the CRP levels,WBC,red blood cells(RBC)and platelet(PLT)counts did not differ among the4 groups(P>0.05).In con- trast,There were a significant increase in the eosinophil counts in the severe VAP group compared with the other 3 groups( P<0.01),the plasma fibrinogen,ET-1 and vWF levels were significantly higher in the severe VAP group than that in the other 3 groups(P<0.05).The eosinophil counts,plasma fibrinogen,ET-1 and vWF after medical therapy in patients with VAP were reduced significantly to the same levels as those in the control group(P<0.01).Conclusion The eosino- phil counts and plasma fibrinogen,ET-1 and vWF levels could predict the severity of VAP.This study suggests that coro- nary vasospasm could result in an increase in eosinophil counts and plasma fibrinogen,ET-1 and vWF levels.
Keywords:Angina pectoris  Vasospasm  Eosinophil  Fibrinogen  ET-1  vWF
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