不稳定性心绞痛患者体内P-选择素的变化及意义

目的 探讨P-选择素在不稳定性心绞痛（UA）发生、发展中的作用,以及与脂质代谢、氧化应激的相关性.方法 选择病例组冠心病（CHD）患者68例,包括稳定性心绞痛（SA）患者20例,UA患者48例,对照组正常人20例,分别测定血浆和血小板内P-选择素含量以及血脂（血清TC、TG、LDL-C、HDL-C）、超氧化物歧化酶（SOD）、丙二醛（MDA）含量,同时分析P-选择素与血脂、脂质过氧化物的相关性.结果 UA患者血浆及血小板内P-选择素含量均显著高于SA患者和正常对照者（均P＜0.01）,而SA患者血浆及血小板内P-选择素含量与正常对照组相比差异无统计学意义（P＞0.05）.血浆P-选择素与血小板P-选择素、TG、LDL-C、MDA水平成明显正相关（均P＜0.01）,而与SOD水平成明显负相关（P＜0.01）.结论 UA患者体内P-选择素含量明显升高,提示血小板活性增强,其原理可能与脂质代谢紊乱以及氧化应激增强有关.

Study on change and its significance of P-selectin in patients with unstable angina pectoris

Objective To study the effect of P-selectin on the pathogenesis and the development of unstable angina pectoris(UA),and the influence of lipid metabolism,oxidative stress on P-selectin.Methods 68 patients with coronary heart disease(CHD),including 48 patient with UA,20 patients with stable angina pectoris(SA) were chosen as CHD group;20 normal cases were chosen as control group.Levels of plasma and platelet P-selectin as well as blood lipid(TC,TG,LDL-C,HDL-C),malonyldiadehyde(MDA),superoxide dismutase(SOD) were measured in a series of ways,and the correlations of P-selectin to blood lipid and lipid peroxidate were also analyzed.Results Compared with the normal cases and patients with SA,the levels of plasma and platelet P-selectin were significantly elevated in patients with UA(all P<0.01),while the levels of plasma and platelet P-selectin were not significantly changed in patients with SA(P>0.05).There were positive correlations between plasma P-selectin and platelet P-selectin,TG,LDL-C,MDA(all P<0.01),and negative correlations between plasma P-selectin and SOD(P<0.01).Conclusion The levels of P-selectin in patients with US are significantly elevated,which suggests that there is a pronounced activation of platelet,and the mechanisms might be related with lipid metabolism and oxidative stress.