急性冠脉综合征患者血清PTX-3水平变化及临床意义

目的探讨血浆五聚素3(Pentraxin-3,PTX-3)在评估急性冠状动脉综合征(acute coronary syndrome,ACS)病情严重程度中的作用。方法选择ACS患者90例,根据美国心脏病学学院/美国心脏学会(ACC/AHA)指南分为不稳定型心绞痛组(UAP组)26例,ST段抬高型心肌梗死组31例(STEMI组),非ST段抬高型心肌梗死组(NSTEMI组)33例,另选同期健康体检者30例作为对照组。采用酶联免疫吸附试验(ELISA)检测血清PTX-3及全自动生化分析仪检测血清超敏C反应蛋白(hs-CRP)并进行组间比较。结果血清PTX-3和hs-CRP水平UAP组、STEMI组和NSTEMI组显著高于对照组(P0.05),STEMI组和NSTEMI组显著高于UAP组,差异均有统计学意义(P均0.05),但STEMI组和NSTEMI组比较差异无统计学意义(P0.05)。相关分析显示血清PTX-3与总胆固醇(TC)、甘油三酯(TG)及低密度脂蛋白胆固醇(LDL-C)、hs-CRP呈明显正相关(r=0.484,r=0.572,r=0.587,r=0.866;P均0.01),与高密度脂蛋白胆固醇(HDL-C)呈明显负相关(r=-0.497,P0.01)。结论血清PTX-3参与了ACS的发生、发展,可用于ACS患者的病情评估。

Changes of Serum PTX-3 in Patients with Acute Coronary Syndromes

Objective To explore the roles of PTX-3 in the assessment of the severity of acute coronary syndromes. Methods 90 patients with acute coronary syndrome were divided into unstable angina pectoris （UAP） group （n=26）, ST segment elevation MI （STEMI） group （n=31）, and non-ST segment elevation MI （NSTEMI） group （n=33） according to guidelines of ACC/AHA. 30 healthy volunteers were enrolled as control group. Serum PTX-3 level were measured with en-zyme-linked absorbed assay. The level of hs-CRP was determined by using an automated measurement method. Results The levels of PTX-3 and hs-CRP in UAP, STEMI and NSTEMI groups were significantly higher than those in the control group （P〈0. 05）. The levels of PTX-3 and hs-CRP in STEMI and NSTEMI groups were significantly higher than those in UAP group, all with significant differences （ P〈0. 05 ） . There was no significant difference between STEMI group and NSTEMI group. Pearson collection analysis, serum PTX-3 level were positively correlated with the levels of total cholesterol （ TC） , tri-glyceride （TG）, low density lipoprotein cholesterol （LDL-C） and hs-CRP （r=0. 484, r=0. 572, r=0. 587, r=0. 866;P〈0. 01）, was negatively correlated with the level of high density lipoprotein cholesterol （HDL-C） （r = -0. 497, P 〈0. 01）. Conclusion The level of serum PTX-3 may play an important role in the pathogenesis of ACS and may be useful in assessment of the severity of acute coronary syndrome.