细胞间粘附分子-1和C反应蛋白在急性冠脉综合征患者中的表达及临床意义

目的观察不稳定性心绞痛(UAP)和急性心肌梗死(AMI)患者血清可溶性细胞间粘附分子-1(sICAM-1)和超敏C反应蛋白(hs-CRP)水平的变化,探讨炎症标志物与急性冠脉综合征发病的关系及临床意义.方法选择急性冠脉综合征患者56例(包括AMI组26例、UAP组30例),以同期住院的冠状动脉造影检查正常的30例患者作为对照组,进行对比研究.采用酶联免疫吸附测定法测定血清sICAM-1和hs-CRP水平,并记录每例患者狭窄程度＞50%的冠状动脉病变数.结果血清sICAM-1浓度在AMI组明显高于UAP组及对照组,在UAP组明显高于对照组;血清hs-CRP浓度在AMI组明显高于UAP组及对照组,但UAP组与对照组比较无显著差异;直线相关分析显示,血清sICAM-1水平与受累冠状动脉血管病变数相关,而hs-CRP水平与受累冠状动脉血管病变数无相关关系.结论炎症参与了急性冠脉综合征的发病,炎症因子sICAM-1血清水平升高与急性冠脉综合征的发生密切相关,还与动脉粥样硬化的范围和程度相关,可以作为监测急性冠脉综合征病情的指标,而hs-CRP水平升高主要与其稳定性有关.

Expression and clinical significance of intercellular adhesion molecule-1 and C-reactive protein in patients with acute coronary syndrome

Objective To investingate the relationship between inflammatory markers and acute coronary syndrome(ACS) by observing changes of serum soluble intercellular adhesion molecule-1 (sICAM-1) and high sensitivity C-reactive protein (hsCRP) in patients with acute myocardial infarction or unstable angina pectoris. Methods Fifty-six patiens with acute coronary syndrome were studied, of whom, 26 were diagnosed as acute myocardial infarction(AMI) and 30 unstable angina pectoris(UAP). The study group was compared with a control group of 30 cases who were identified as normal by coronary angiography. The concentrations of serum sICAM-1 and hs-CRP were determined by ELISA. The number of stenotic coronary arteries was recorded. Results Serum sICAM-1 levels were significantly elevated in patients with AMI or UAP vs control group, while hs-CRP was increased only in patients with AMI vs UAP and the control group. By linear regression analysis, only serum sICAM-1 levels were correlated with the number of stenotic coronary arteries. Conclusions Inflammation is involved in the process of ACS. As an inflammatory factor, serum sICAM-1 level is correlated with the extent of coronary artery lesion and the initiation of ACS, and can be used as an index for determining the condition of patients, while hs-CRP is mainly related to the disease stability.