冠心病患者血浆中单核细胞趋化蛋白-1的意义

目的:观察冠心病患者血浆中单核细胞趋化蛋白-1(MCP-1)的浓度,探讨其诊断冠心病的意义及临床价值。方法:将122例患者分为非冠心病组(30例)、稳定型心绞痛组(32例)、不稳定型心绞痛组(27例)和急性心肌梗死组(33例),应用酶联免疫吸附法检测患者血浆中MCP-1、组织因子(TF)的浓度。结果:①血浆中MCP-1、TF的浓度均为:非冠心病组<稳定型心绞痛组<不稳定型心绞痛组<急性心肌梗死组(均P<0.05)。②血浆中MCP-1的浓度与患者的性别、吸烟、冠心病家族史、高血压和糖尿病、TG、HDL-C、尿素氮、肌酐无明显相关性(均P>0.05),与年龄、体质指数、TC、LDL-C、尿酸、心肌肌钙蛋白I、肌酸激酶同工酶、TF呈正相关性(均P<0.05)。③以血浆中MCP-1的浓度作为诊断急性冠状动脉综合征的指标,ROC曲线分析结果显示MCP-1的诊断价值较大,曲线下面积0.939(P<0.05),最佳临界值为320.5ng/L,其特异度和灵敏度分别是86.7%和88.0%。结论:血浆中MCP-1在判断冠状动脉粥样硬化斑块易损性方面有一定的临床意义,可能是冠心病的一个独立危险因素,可作为诊断急性冠状动脉综合征的理想指标。

Significance of plasma monocyte chemotactic protein-1 in patients with coronary heart disease

Objective:To investigate the significance and clinical value of plasma monocyte chemotactic protein-1(MCP-1) in diagnosis of coronary heart disease(CHD) by observation of the concentrations of plasma MCP-1 in patients with CHD.Method:One hundred and twenty-two patients were divided into Non-CHD group(control group,n=30),SAP group(n=32),UAP group(n=27) and AMI group(n=33).In all these groups,the concentrations of plasma MCP-1 and tissue factor(TF) in the patients were detected by ELLSA.Result:①The concentrations of plasma MCP-1 and TF were: control group0.05),but it was positively correlated with age,BMI,TC,LDL-C,uric acid,cTnI,CK-MB and TF(all P<0.05).③Using concentration of plasma MCP-1 as a diagnostic indicator of acute coronary syndrome,ROC curve analysis showed that MCP-1 had diagnostic value,the area under ROC curve of MCP-1 was 0.939(P<0.05),the best critical concentration of plasma MCP-1 was 320.5 ng/L,the specificity and sensitivity were 86.7% and 88.0%.Conclusion:Plasma MCP-1 may have clinical significance in reflecting the vulnerability of atherosclerotic plaque,it may be an independent risk factor of CHD and a good indicator in diagnosis of acute coronary syndrome.