急性与慢性冠状动脉综合征患者电子束CT冠状动脉钙化的比较

目的：比较急性与慢性冠状动脉综合征患电子束CT（EBCT）冠状动脉钙化（CAC）的不同模式。方法：264例患（包括67例SAP、94例UAP和103例AMI）行选择性冠状动脉造影以检测粥样硬化狭窄的程度，行EBCT检查以计算CAC积分，分析各组患CAC积分的差异及其与狭窄程度的关系。结果：（1）SAP组CAC检测阳性率为100％，显高于UAP组的87．23％和AMI组的86．41％（P＜0．05）。（2）SAP组严重钙化的病人和动脉比例显高于UAP组和AMI组（P＜0．05），钙化积分自然对数转换值（In[CS 1])的均数SAP组显高于UAP组和AMI组（P＜0．001）。（3）不同CAC程度在不同狭窄冠状动脉上的分布在SAP组与UAP组有明显差异。（4）AMI组梗死相关动脉多数无钙化或仅有轻度钙化，钙化积分显低于非梗死相关动脉。结论：应用电子束CT研究显示，急性与慢性冠状动脉综合征患存在不同的冠状动脉钙化模式，此点有助于理解这两类冠心病之间在临床和病理方面的差异。     

冠状动脉瘤样扩张与电子束CT检测的冠状动脉钙化

为探讨冠状动脉瘤样扩张患者电子束CT检测的冠状动脉钙化的特点及其临床和病理意义 ,将 2 7例经选择性冠状动脉造影确诊的冠状动脉瘤样扩张患者行电子束CT检查以计算钙化积分 ,并与 2 7例年龄和性别匹配的冠状动脉造影正常者进行比较。结果发现 ,冠状动脉瘤样扩张组钙化阳性率、钙化积分中位数及钙化积分的自然对数转换值均显著高于正常对照组 (P <0 .0 1或 0 .0 0 1)。冠状动脉瘤样扩张组中 2 1例粥样硬化性瘤样扩张患者钙化阳性率为 81.0 % ;弥漫性扩张动脉的钙化积分对数转换值显著低于局限性扩张动脉 (1.2 2± 1.79比 2 .86± 1.85 ,P <0 .0 5 )。结果提示 ,粥样硬化性冠状动脉瘤样扩张患者多数存在较为广泛的冠状动脉钙化 ,且钙化程度与病变类型有关。     

血清基质金属蛋白酶3水平与冠心病及冠状动脉病变程度的关系研究

目的探讨血清基质金属蛋白酶3(MMP-3)水平与冠心病及冠状动脉病变程度的关系。方法选择2010年6月—2012年6月江苏大学附属武进人民医院心内科收治的冠心病患者127例,其中急性心肌梗死(AMI)患者50例(AMI组)、不稳定型心绞痛(UAP)患者37例(UAP组)、稳定型心绞痛(SAP)患者40例(SAP组)。另外选择同期在我院体检健康者50例作为对照组。采用ELISA法测定各组受检者血清MMP-3水平,比较各组受检者及不同冠状动脉病变支数患者血清MMP-3水平。结果对照组受检者血清MMP-3水平为(1.85±0.86)μg/L,SAP组为(1.77±0.96)μg/L,UAP组为(4.22±2.81)μg/L,AMI组为(6.37±1.68)μg/L。AMI组患者血清MMP-3水平UAP组SAP组和对照组(P0.05)。冠状动脉单支病变患者血清MMP-3为(3.72±1.88)μg/L,双支病变患者为(4.22±1.92)μg/L,三支病变患者为(4.86±2.24)μg/L,不同冠状动脉病变支数患者血清MMP-3水平比较,差异无统计学意义(F=0.438,P0.05)。结论血清MMP-3水平与冠心病患者冠状动脉病变程度无明显关系,但与动脉粥样硬化斑块的不稳定性有关,是急性冠脉综合征(ACS)的重要血清标志物。     

X综合征女性患者电子束CT测定冠状动脉钙化的临床特点

为探讨X综合征女性患者冠状动脉钙化及临床情况 ,利用电子束CT对 2 6例X综合征女性患者和 2 2例冠状动脉造影及运动试验均正常的女性胸痛者冠状动脉进行检测 ,同时对其冠心病危险因子进行评估 ,测定血脂和血浆氧化型低密度脂蛋白水平 ,对比不同病例的冠状动脉钙化积分及病变血管支数。结果发现 ,有 19例(73% )X综合征女性患者存在冠状动脉钙化 ,而正常组中仅 4例 (18% )存在冠状动脉钙化 ;有冠状动脉钙化的X综合征女性患者冠心病危险因子明显高于正常组 (1.8± 1.3比 1.1± 0 .9,P <0 .0 5 ) ,前者的血浆氧化型低密度脂蛋白浓度也明显高于后者 (5 2 .38± 6 .89比 39.92± 7.87,P <0 .0 5 ) ;其中 13例为绝经期患者。绝经后X综合征患者冠状动脉钙化积分和有冠状动脉钙化的血管支数与非绝经期者相比无明显差异 ,但这两组均较正常组明显增高 (P<0 .0 5 )。结果提示 ,有相当数量的X综合征女性患者存在冠状动脉钙化 ,这种钙化似乎与绝经与否无关 ,有必要对这类患者的临床资料进行评估并作相应治疗     

Small coronary calcium deposits and elevated plasma levels of oxidized low density lipoprotein are characteristic of acute myocardial infarction

AIM: Predictions of the onset of acute myocardial infarction (AMI) in high risk individuals are of great clinical importance. Among various risk factors, elevated levels of oxidized low density lipoprotein (ox-LDL) in plasma have been shown to reflect unstable coronary plaques. Coronary calcification is a common finding in the elderly, however, its clinical implications as a risk factor for plaque rupture are controversial. This study was designed to investigate the clinical implications of plasma ox-LDL levels and coronary calcification detected by electron-beam computed tomography (EBCT), by comparing patients with AMI with those with stable angina pectoris (SAP). METHODS: We measured plasma ox-LDL levels in AMI (n=34) and SAP (n=49) patients. In addition, a coronary calcium score was quantified with the Agatston system. The total coronary calcium score (TCS) was defined as the sum of the scores for each lesion. RESULTS: TCS and total calcium area were significantly smaller in patients with AMI than in those with SAP. On the other hand, plasma ox-LDL levels were significantly higher in AMI patients than in SAP patients (p<0.0005). CONCLUSION: These results suggest that a combined assessment of coronary calcium and plasma ox-LDL levels may be useful for screening patients with unstable coronary plaques.     

联合检测生化标志物在急性冠脉综合征患者中的相关性比较

目的 观察急性冠脉综合征(ACS)患者中炎症标志物白介素-6(IL-6)、基质金属蛋白酶-1(MMP-1)、B型尿钠肽(BNP)、超敏C反应蛋白(hs-CRP)及肌钙蛋白I(cTnI)水平及相关性的比较.方法 选取2009年4-9月158例入院初步诊断为冠心病并接受冠状动脉造影患者,根据临床表现、心电图、心肌酶谱及冠状动脉造影结果 分为4组,不稳定型心绞痛(UAP)48 例、急性心肌梗死(AMI)42 例、稳定型心绞痛(SAP)34 例,冠脉造影正常者34例作为对照组.检测患者外周静脉血清IL-6、MMP-1、hs-CRP及cTnI水平,并比较各组IL-6、MMP-1、BNP、hs-CRP及cTnI水平并分析 IL-6、MMP-1、BNP、hs-CRP及cTnI之间的相关性.结果 (1)UAP组和AMI组血清 IL-6、MMP-1、BNP、hs-CRP水平明显高于对照组和SAP组,差异有统计学意义(P＜0.01);UAP组与AMI组、对照组与 SAP组血清IL-6、MMP-1水平差异均无统计学意义(P＞0.05);AMI组血清BNP与hs-CRP水平高于UAP组,差异有统计学意义(P＜0.05);(2)ACS患者中IL-6及MMP-1与hs-CRP、BNP与cTnI分别呈正相关;ACS患者中hs-CRP与cTnI无直线相关.结论 急性冠脉综合征患者中明显高表达炎性生化标志物,联合检测多生化标志物可能对急性冠脉综合征早期诊断具有积极的临床意义.     

冠状动脉支架术对冠心病患者血小板活化功能的影响

目的探讨冠心病患者行冠状动脉内支架置入术前后血小板活化指标的变化,了解冠心病不同临床类型支架置入数与血小板活化指标之间的关系。方法利用流式细胞术和单克隆抗体测定48例稳定型心绞痛、45例不稳定型心绞痛患者与37例急性心肌梗死患者外周血中血小板膜糖蛋白CD62p、CD63和凝血酶敏感蛋白的阳性表达率,并与45例冠状动脉造影正常者作对照分析。结果稳定型心绞痛患者、不稳定型心绞痛患者和急性心肌梗死患者支架置入后CD62p、CD63和凝血酶敏感蛋白的阳性表达率均显著高于支架置入前(P<0.01);不稳定型心绞痛组和急性心肌梗死组治疗前亦高于对照组(P<0.01),而稳定型心绞痛组治疗前与对照组比较差异无显著性(P>0.05)。稳定型心绞痛组和不稳定型心绞痛组CD62p、CD63和凝血酶敏感蛋白的阳性表达率与支架置入个数有关,置入支架越多阳性表达率越高。结论不稳定型心绞痛患者及急性心肌梗死患者存在血小板高活化状态、动脉粥样硬化斑块破裂以及急性血栓形成。支架置入术对冠状动脉内皮的损伤加强了血小板的活化,增加了血栓形成的风险。     

电子束CT检测冠状动脉钙化对诊断老年冠心病的价值

目的　探讨电子束CT检测冠状动脉钙化 (CAC)对诊断老年人冠心病的价值。方法　 2 2 9例老年患者行电子束CT检测CAC并计算每例的CAC总积分 ,行选择性冠状动脉造影以确定冠状动脉粥样硬化狭窄的有无及其程度。结果　 (1) 2 2 9例患者中 ,CAC检测阳性 2 2 0例 ,总阳性率 96 .0 7% ;造影显示有 2 13例存在不同程度的冠状动脉狭窄 ,其中 16 8例确诊为冠心病。 (2 )全组CAC诊断老年人冠心病的总体敏感性、特异性、阳性预测值和阴性预测值分别为 99%、13%、76 %和 89% ,诊断老年人冠状动脉粥样硬化的相应指标则分别为 97%、19%、94%和 33%。(3)老年男性组CAC诊断冠心病的敏感性较高特异性较低 ;老年女性则特异性较高而敏感性较低。综合考虑敏感性及特异性 ,对于老年男性 ,以CAC积分为 2 0 0作为诊断冠心病的分值较好 ,而对于老年女性则以 5 0作为诊断分值较佳。结论　电子束CT检测冠状动脉钙化对诊断老年人冠心病具有一定价值 ,但应结合性别和钙化分值进行综合分析。     

纤溶指标的变化与急性冠状动脉事件的关系

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D-二聚体定量检测对判定急性冠脉综合征血栓形成的研究

目的：探讨D-二聚体定量检测对于判定急性冠脉综合征（ACS）血栓形成的意义。方法：选择住院不稳定型心绞痛（UAP）患者36例,急性心肌梗塞（AMI）患者13例,稳定型心绞痛（SAP）患者23例,采用胶体金标法动态检测患者静脉血中的D-二聚体含量。结果：D-二聚体含量：UAP组（0．95±0．32）mg／L,AMI组（1．82±0．63）mg／L,UAP组与SAP组（0．39±0．15）mg／L比较有显著差异（P〈0．05）,AMI组与SAP组比较,差异非常显著（P〈0．01）。结论：D-二聚体定量检测是判定ACS血栓形成相对特异的敏感指标。     

Activation of clotting factors XI and IX in patients with acute myocardial infarction

In acute coronary events, plaque rupture and the subsequent formation of the catalytic tissue factor-factor VIIa complex is considered to initiate coagulation. It is unknown whether clotting factors XI and IX are activated in acute coronary events. Therefore, we prospectively investigated the activation of clotting factors XI and IX as well as activation of the contact system and the common pathway in 50 patients with acute myocardial infarction (AMI), in 50 patients with unstable angina pectoris (UAP), and in 50 patients with stable angina pectoris (SAP). Factor XIa-C1 inhibitor complexes, which reflect acute activation of factor XI, were detected in 24% of the patients with AMI, 8% of the patients with UAP, and 4% of the patients with SAP (P<0.05), whereas factor XIa-alpha(1)-antitrypsin complexes, which reflect chronic activation, were observed equally in all 3 study groups. Factor IX peptide levels were significantly higher in the patients with AMI and UAP compared with the patients with SAP (P<0.01). No differences regarding markers of the common pathway were demonstrated. Fibrinopeptide A levels were elevated in patients with AMI compared with patients with UAP and those with SAP (P<0.01). Factor XIIa- or kallikrein-C1 inhibitor complexes were not increased. In conclusion, this is the first demonstration of the activation of clotting factors XI and IX in patients with acute coronary syndromes. Because these clotting factors are considered to be important for continuous thrombin generation and clot stability, their activation might have clinical and therapeutic consequences.     

急性冠状动脉综合征患者血浆MMP-2、MMP-9水平变化的临床观察

目的探讨MMP-2和MMP-9在急性冠状动脉综合征(ACS)患者中的变化及意义。方法通过对141例ACS(其中急性心肌梗死98例,不稳定性心绞痛43例)患者,与40例稳定性心绞痛(SAP)和40例冠状动脉正常(NCA)患者作对照,测定血清中MMP-2、MMP-9的浓度,同时对急诊PCI术者在术后1周再次测血浆中MMP-2和MMP-9的表达。结果与NCA组及SAP组比较,ACS组中MMP-2、MMP-9显著升高,差异有统计学意义(P0.01),且术后1周病情稳定后明显降低,与术前比较差异有统计学意义(P0.01)。与冠状动脉单支病变相比,双支及三支病变的患者血清中MMP-2、MMP-9显著升高,差异有统计学意义(P0.01)。结论 MMP-2、MMP-9可作为反映ACS患者动脉粥样硬化斑块不稳定或破裂的血清学指标,并有助于冠状动脉病变严重程度的危险分层。     

Gender and age differences in the prevalence of coronary artery calcification in 953 Chinese subjects

BACKGROUND: To investigate gender and age differences in coronary artery calcium (CAC) as determined by electron beam computed tomography (EBCT) in a Chinese population. METHODS: Consecutive patients undergoing EBCT were subdivided into groups based on gender and decades of life. They were further subdivided into three groups with respect to symptoms of coronary artery disease: typical, atypical and asymptomatic. Total calcium score was calculated for each patient and means calculated for each subgroup. Groups were then compared with respect to age, gender and symptoms. RESULTS: During the study period, 953 patients (736 men and 217 female) aged 17-86 years (mean 55+/-11 years) underwent EBCT. The prevalence of CAC increased significantly with increasing age. The mean total calcium score also increased with increasing age in males and females of each symptom subgroup. The prevalence of coronary artery calcification was significantly higher in males than females until age in excess of 69 years (p<0.05). The prevalence of coronary artery calcification and mean calcium scores were significantly different between each symptom subgroup (p<0.001) with higher scores and prevalence in patients with typical symptoms of coronary disease. CONCLUSIONS: There is an increase in the prevalence of coronary artery calcification with age in Chinese subjects. Male subjects are more likely than female subjects to have detectable coronary calcification up until an age in excess of 69 years. Patients under the age of 70 years, with typical symptoms of coronary artery disease have a higher prevalence and mean calcium score than those with atypical or no symptoms.     

Calcification in culprit lesions of coronary artery disease

Coronary calcification, a type of coronary atherosclerosis, has recently been closely examined in clinical cardiology because its presence may influence the selection of interventional therapy. In addition, plaque instability is one of the most important factors in the mechanism of acute coronary syndrome, and calcium deposit is frequently detected in advanced lesions. However, little is known about the clinical significance of coronary calcification. The incidence of calcium deposits was investigated in the culprit lesions (culprit coronary calcification) of patients with serious coronary artery disease to discover any cardioprotective effect. Initial coronary angiography was performed in 179 consecutive patients with acute myocardial infarction with Q wave on electrocardiography (AMI group; male 139, female 40, mean age 60.2 +/- 10 yr) and in 119 consecutive patients with stable effort angina pectoris (SAP group; male 78, female 41, mean age 63.8 +/- 8 yr) for which balloon plasty or bypass surgery was necessary from 1990 to 1997. Culprit coronary calcification was defined positive if the calcification deposit was present cinefluoroscopically within 5 mm from the culprit point. The culprit point was defined as the narrowest point after successful intracoronary thrombolytic therapy or the latest point to be dilated during a balloon inflation in direct or rescue percutaneous transluminal coronary angioplasty in the AMI group, and the narrowest point of the culprit lesion in the SAP group. There was no statistical difference in clinical background between the 2 groups other than male dominance in the AMI group and high incidence of family history of ischemic heart disease in the SAP group (p < 0.05). Culprit coronary calcification in patients over 50 years old was less frequently positive in the AMI group than the SAP group (26% vs 66%, p < 0.005, respectively). In younger patients under 50 years old, the incidence of culprit coronary calcification was low (14-15%) in both groups. Culprit coronary calcification was frequently positive in the right or the left anterior descending coronary artery in the SAP group (p < 0.005). There was no incidental sex difference of culprit coronary calcification. This comparison suggests that if a plaque contains cinefluoroscopically visible calcification, it may be regarded as less vulnerable or having a history of chronic process of atherosclerosis which results in protecting plaque rupture.     

冠心病患者血清可溶性E-选择素检测的意义

目的　探讨血清可溶性E 选择素在监测冠心病病情及与冠状动脉病变程度的关系。方法　 81例冠心病患者 ,按临床诊断分为 4组 :急性心肌梗死 (AMI) 17例、不稳定性心绞痛 (UAP) 2 4例、稳定性心绞痛 (SAP) 2 0例和对照组患者 2 0例。检测各组患者血清可溶性E 选择素的水平 ,并比较各组间的差异。对冠心病患者的冠状动脉损害行Gensini评分 ,并与其血清可溶性E 选择素水平进行直线相关分析。结果　 (1)AMI组、UAP组及SAP组的血清可溶性E 选择素水平比对照组高 ;(2 )AMI组、UAP组可溶性E 选择素水平和SAP组相比 ,其值增加明显 ;AMI组和UAP组结果相似 ;(3)急性冠脉综合征 (AMI组 +UAP组 )血清可溶性E 选择素水平与冠状动脉Gensini评分呈正相关。结论　血清可溶性 E选择素可能是冠状动脉粥样硬化的标志 ,参与了冠心病的发病过程 ,在急性冠脉综合征中 ,其值与冠状动脉病变程度密切相关。     

胰岛素样生长因子-1与冠状动脉造影对照研究

目的探讨胰岛素样生长因子-1（IGF-1）与急性冠状动脉综合征（ACS）的关系,并且通过冠状动脉造影研究IGF-1与冠状动脉狭窄及其程度的关系。方法将114例入院患者行冠状动脉造影后分为4组,稳定型心绞痛组（SAP）24例,不稳定型心绞痛组（UAP）33例,急性心肌梗死组（AMI）26例,冠状动脉照影无狭窄或狭窄小于25%者为对照组31例。用ELISA法测定其外周静脉血清IGF-1水平,分析各组IGF-1水平之间的关系以及冠状动脉狭窄程度与IGF-1水平的关系。结果①UAP组、AMI组血清IGF-1浓度较对照组、SAP组明显降低,且差异有统计学意义[（19.02±9.65）μg/L,（16.56±6.64）μg/L和（34.89±7.09）μg/L,（31.06±8.64）μg/L,P〈0.05],SAP组血清IGF-1浓度较对照组降低,但差异无统计学意义[（31.06±8.64）μg/L和（34.89±7.09）μg/L,P〉0.05],AMI组血清IGF-1浓度较UAP组降低,但差异无统计学意义[（16.56±6.64）μg/L和（19.02±9.65）μg/L,P〉0.05];②血清IGF-1浓度与其相应的冠状动脉狭窄积分呈明显负相关（r=-0.659,P〈0.05）。结论血清IGF-1浓度可能作为预测急性冠脉综合征及冠状动脉狭窄程度的参考指标之一。     

Usefulness of high-sensitivity C-reactive protein in predicting long-term risk of death or acute myocardial infarction in patients with unstable or stable angina pectoris or acute myocardial infarction.

High-sensitivity C-reactive protein (CRP), proposed as a new coronary risk marker, may reflect either an acute phase reaction or the level of chronic inflammation. Thus, CRP may be less predictive of long-term outcomes when measured after acute myocardial infarction (AMI) than after unstable angina pectoris (UAP) or stable angina pectoris (SAP). A total of 1,360 patients with severe coronary artery disease (>/=1 stenosis >/=70%) had CRP levels obtained at angiography. Presenting diagnoses were SAP (n = 599), UAP (n = 442), or AMI (n = 319). During follow-up (mean 2.8 years), death or nonfatal AMI (D/AMI) occurred in 19.5%, 16.1%, and 17.2% (p = NS) with SAP, UAP, and AMI, respectively. Corresponding median CRP levels were 1.31, 1.27, and 2.50 mg/dl (p <0.001). For the overall cohort, increasing age, low ejection fraction, revascularization, and elevated CRP were the strongest of 6 independent predictors for D/AMI. Among those presenting with SAP, CRP levels above the first tertile were associated with an adjusted hazard ratio of 1.8 (95% confidence interval [CI] 1.2 to 2.8, p <0.009) for D/AMI. After UAP, the hazard ratio was 2.7 (95% CI 1.4 to 5.0, p <0.002). However, when measured during hospitalization for AMI, CRP was not predictive of long-term outcome (hazard ratio 1.0 [95 % CI 0.5 to 1.7] p = 0.86). In conclusion, predischarge CRP levels are higher after AMI than after UAP or SAP. However, whereas CRP is strongly predictive of long-term D/AMI for patients presenting with SAP or UAP, it is not predictive shortly after AMI, suggesting that measurements should be delayed until the acute phase reaction is over and levels have returned to baseline.     

血浆SDF-1α、TGF-β1水平与不同类型冠心病患者和冠状动脉狭窄程度的相关性

目的 探讨血浆基质细胞衍生因子-1α（SDF-1α）、转化生长因子-β1 (TGF-β1)与不同类型冠心病和冠心病冠脉狭窄程度的相关性。方法 124 例患者分为:稳定型心绞痛（SAP）组32例、不稳定型心绞痛（UAP）组30例、急性心肌梗死（AMI）组32例及对照组30 例。ELISA法测定血浆SDF-1α、TGF-β1水平;并冠脉造影,用Gensini积分评定冠状动脉狭窄程度。结果 ①血浆SDF-１α、TGF-β1水平SAP组、UAP组、AMI组低于对照组(P<0.01),UAP组、AMI组低于SAP组(P<0.01),AMI 组低于UAP组(P<0.01);②血浆SDF-1α水平与SAP组、UAP组、AMI组Gensini积分的相关系数分别为:r=-0.31,P=0.0749;r=-0.69,P=0.0036;r=-0.76,P=0.0049;TGF-β1与各组Gensini积分的相关系数分别为:r=-0.19,P=0.1592;r=-0.71,P=0.0037;r=-0.77,P=0.0029;③血浆SDF-1α、TGF-β1水平在单支病变、双支病变和三支病变组间差异显著(P<0.01),与病变血管支数成负相关（r=-0.65,P=0.0218;r=-0.73,P=0.0065）。结论 冠心病患者血浆SDF-1α、TGF-β1水平降低,与冠心病严重程度及冠状动脉狭窄程度呈负相关。     

钙结合蛋白S100A12与冠状动脉粥样斑块稳定性的相关性

目的 探讨冠心病患者血清钙结合蛋白S100A12的表达及其与冠心病的相关性,评价其作为预测斑块稳定性的外周血生物学指标的临床意义.方法 选择依据临床症状及冠脉造影结果冠心病诊断明确的患者91例,其中稳定型心绞痛（SAP组）18例、不稳定型心绞痛（UAP组） 37例、急性心肌梗死（AMI组）（包括ST段抬高型心梗和非ST段抬高型心梗） 36例.对照组为冠脉造影正常或微小病变＜50%排除冠心病的患者34例.观察血清S100A12水平在各组间的变化.通过介入手术模拟斑块破裂,比较术前、术后S100A12水平变化,评价其预测斑块稳定性的临床意义.结果 ①冠心病患者（SAP组、UAP组、AMI组）血清S100A12水平显著高于对照组（P＜0.05）;与SAP组比较,UA组及AMI组血清S100A12水平显著升高,且差异有统计学意义（P＜0.05）;UAP组与AMI组比较血清S100A12水平差异无统计学意义（P＞0.05）.②根据是否行支架置入术分为单纯行选择性冠脉造影组（CAG组）与选择性冠脉造影＋内支架置入术组（PCI组）.在CAG组中,血清S100A12术后与术前即刻相比差异无统计学意义（P＝0.064）;在PCI组中,术后血清S100A12水平与术前即刻相比显著升高,差异有统计学意义（P＜0.01）.③入院至手术前住院期间药物对血清S100A12水平的影响：所有对象入院时与术前即刻血清S100A12水平相比差异无统计学意义（P＞0.05）.结论 钙结合蛋白S100A12可能参与动脉粥样硬化的形成,并且可能成为外周血中预测斑块稳定性的生物学指标.     

脑钠肽、和肽素和高敏C反应蛋白与急性冠状动脉综合征的相关性

目的 探讨急性冠状动脉综合征患者冠状动脉粥样硬化程度与脑钠肽、和肽素和高敏C反应蛋白水平之间的相关性.方法 检测30例急性心肌梗死(急性心肌梗死组)患者,38例不稳定型心绞痛(不稳定型心绞痛组)患者和20例健康对照组血浆脑钠肽、和肽素和血清高敏C反应蛋白水平;比较冠状动脉病变支数、左主干病变、冠状动脉Gensini评分与脑钠肽、和肽素和高敏C反应蛋白水平的相关性.结果 急性心肌梗死组、不稳定型心绞痛组脑钠肽、和肽素和高敏C反应蛋白水平显著高于正常对照组(P<0.01),急性心肌梗死组脑钠肽、和肽素和高敏C反应蛋白水平显著高于不稳定型心绞痛组(P<0.01);脑钠肽、和肽素水平与冠状动脉病变支数、左主干病变、冠状动脉Gensini评分呈正相关(P<0.01),而高敏C反应水平与冠状动脉病变支数、左主干病变、冠状动脉Gensini评分差异无显著性(P>0.05).结论 急性冠状动脉综合症患者脑钠肽、和肽素和高敏C反应蛋白的水平明显升高,和冠状动脉病变程度之间存在相关性.