循环免疫复合物与冠状动脉粥样硬化斑块的相关性研究

目的 探讨循环免疫复合物(CICs)与冠状动脉斑块特征的相关性.方法 56例急性冠脉综合征(ACS)患者,发病时取血,酶联免疫吸附法(ELISA)检测血浆中CICs和氧化低密度脂蛋白(ox-LDL)等,以及液相蛋白芯片结合流式细胞分析方法 测定几种血管因子;常规冠状动脉造影(CAG).并行血管内超声(IVUS)检测56个靶病变处动脉粥样斑块形态学及性质特征.分析急性心肌梗死(AMI)与不稳定性心绞痛(UA)患者、易损斑块与非易损斑块组、发生斑块破裂时CICs的改变;以及与斑块形态学指标及血管因子的相关性.结果 ClCs和各血管因子浓度在AMI组与UA组之间未见显著性差异(均P>0.05);斑块破裂与非斑块破裂者比较tics浓度有显著性差异(287±26比170±31 mg/L,P=0.018);易损斑块与非易损斑块两组CICs的比较结果 显示,两组之间均无统计学意义(238±29比253±29 mg/L,P=0.78).ACS患者CICs浓度与斑块形态学指标无统计学意义;除组织纤维蛋白溶酶原激活物(t-PA)以外,CICs与其他的动脉粥样硬化形成不同阶段的炎症因子间大部分存在显著相关性;CICs与ox-LDL之间呈明显正相关性(r=0.591,P=0.005).结论 CICs结合其他因素对于ACS患者冠脉斑块破裂和AMI有重要的诊断意义.

Relationship between circulating immune complexs and coronary atherosclerosis plaque

Objective To investigate the relationship between circulating immune complexs (CICs) and coronary artery plaque in the patients with acute coronary syndrome (ACS). Methods 56 patients with" ACS were performed intravascular ultrasound (IVUS). CICs and the others biomarker were tested by ELISA or biochemistry. Flow cytometry was used for seven vascular factors detection. The changes of bio-factors were compared between vulnerable and non-vulnerable plaque groups, acute myocardial infarction (AMI) and unstable angina (UA) patients, and occurring and un- occurring plaque rupture groups. The relationship between the parameters of morphology and CICs were analyzed. Results There was no difference between AMI and UA group in CICs. CICs was increased in the plaque rupture group [(287±26) vs (170 ±31) mg/L, P =0. 018]. CICs was not elevated in the vulnerable plaque group[(238±29) vs (253±29) mg/L,P = 0. 78]. There were not correlation between CICs and plaque morphologic indications. CICs and most of inflammation factors were rela-tionship except t-PA. Between C1Cs and ox-LDL showed strong positive relationship (r = 0. 591, P =0. 005). Condusions CICa combined with others biomarkers may be useful for predicting ACS patients' plaque rupture and myocardial infarction.