血浆甲壳质酶蛋白40和内皮微粒与老年急性冠状动脉综合征的相关性研究

目的:探讨血浆甲壳质酶蛋白40（YKL-40）和内皮微粒（EMP）与老年急性冠状动脉综合征（ACS）之间的相关性。方法:选择行冠状动脉造影检查且年龄≥65岁者180例，随机分为ACS组（n=96）和对照组（n=84）。应用酶联免疫吸附法检测血浆YKL-40水平；应用流式微球技术检测血浆EMP水平，以CD31+/CD42b-EMPs为标志；采用Gensini评分对每支血管病变狭窄程度进行定量计算。结果:ACS组血浆YKL-40和CD31+/CD42b-EMPs水平均明显高于对照组（P<0.01）。ACS组患者Gensini评分值与血浆YKL-40和CD31+/CD42b-EMPs水平均呈正相关关系（r=0.522，P<0.01；r=0.561，P<0.01）。ACS组患者血浆YKL-40水平和CD31+/CD42b-EMPs水平呈正相关关系（r=0.625，P<0.01）。结论:老年ACS患者血浆YKL-40和EMP水平明显升高，且升高水平与冠脉病变程度有关，提示两者有可能成为诊断ACS的一个新的生化标志物，并为冠状动脉病变程度及危险分层提供参考依据。

Correlation of plasma enzyme chitin 40 and endothelial microparticle with acute coronary syndrome in elder patients

Objective: To investigate the correlation of the levels of plasma enzyme chitin 40(YKL-40) and endothelial microparticle(EMP) with the acute coronary syndrome(ACS) in elder patients.Methods: A total of 180 patients(≥65 years old) with coronary angiography were randomly divided into the ACS group(96 cases) and control group(84 cases).The serum levels of plasma YKL-40 and EMP in two groups were measured by Enzyme-linked immunosorbent assays and cytometric bead assay technique labeled by CD31+/CD42b-EMPs,respectively.The vascular stenosis degree was quantified by Gensini score.Results: The levels of the YKL-40 and CD31+/CD42b-EMPs in ACS group were significantly higher than those in control group(P<0.01).The Gensini score was significantly positive correlation with the levels of YKL-40 and CD31+/CD42b-EMPs in ACS group(r=0.522,P<0.01;r=0.561,P<0.01).The level of YKL-40 was significantly positive correlation with the level of CD31+/CD42b-EMPs in ACS group(r=0.625,P<0.01).Conclusions: The levels of plasma YKL-40 and CD31+/CD42b-EMPs in ACS patients increase significantly,which is related to the vascular lesion degree.The YKL-40 and EMP maybe a new biochemical marker in diagnosing ACS,which can provide a reference in identifying the severity and risk stratification of coronary artery lesions.