血清新碟呤与急性冠脉综合征患者冠脉病变程度的相关性

目的:分析血清新碟呤(neopterin,Npt)对评估急性冠脉综合征(ACS)冠状动脉病变的临床价值。方法:经冠状动脉造影(CAG)确诊的126例ACS患者，依据临床类型分为:ST段抬高型心肌梗死(STEMI)组45例，非ST段抬高型心肌梗死(NSTEMI)组40例，不稳定型心绞痛(UAP)组41例。采用ELISA法测定并比较各组血清Npt、白细胞介素-8(IL-8)及超敏C反应蛋白(hs-CRP)水平，分析其与冠状动脉病变类型及斑块类型的关系。结果:血清Npt浓度在STEMI组中高于NSTEMI及UAP组(P<0.05)，而IL-8及hs-CRP在3组中无显著差异。血清Npt浓度在冠脉复杂病变中显著高于冠脉简单病变与冠脉临界病变(P<0.05)，而IL 8及hs CRP在3种病变中无显著差异。Ⅱ型、Ⅲ型斑块患者中血清Npt浓度高于Ⅰ型斑块患者(P<0.05)，而IL-8及hs-CRP在3种斑块类型中无显著差异。结论:血清Npt与冠脉综合征患者冠脉病变程度相关，可能成为有效评估ACS患者冠脉病变程度的一个指标。

Value of serum neopterin in assessing coronary artery lesions in patients with acute coronary syndrome

AIM:To explore the clinical value of serum neopterin (Npt) in assessing coronary artery lesions in patients with acute coronary syndrome (ACS). METHODS: One hundred and twenty six patients with ACS confirmed by coronary angiography (CAG) were divided into ST segment elevation myocardial infarction (STEMI) group (n=45), non ST segment elevation myocardial infarction (NSTEMI) group (n=40) and unstable angina pectoris (UAP) group (n=41). Serum levels of Npt, IL 8 and hs CRP were detected by enzyme linked immunosorbent assay (ELISA) and were compared among the three groups. The relationship between neopterin and types of coronary artery lesions and plaques was analyzed. RESULTS: Serum level of Npt in STEMI group was obviously higher than in the NSTEMI and UAP groups (P<005), but no significant differences were found in the serum levels of IL 8 and hs CRP among the three groups. Serum level of Npt in complex coronary lesions was obviously higher than in simple coronary lesions and borderline coronary lesions (P<005), but no significant differences were observed in the serum levels of IL 8 and hs CRP among the three types of coronary lesions. The serum level of Npt in type I and II plaques was obviously higher than in type III plaques (P<005), but there were no significant differences in serum levels of IL 8 and hs CRP in the three types of coronary plaques. CONCLUSION: Neopterin can be used to effectively evaluate coronary artery lesions in patients with ACS.