尿激酶型纤溶酶原激活物与冠心病临床类型的关系

目的 探讨冠状动脉粥样硬化性心脏病（冠心病）患者血清尿激酶型纤溶酶原激活物（urokinase-type plasminogen activator,uPA）浓度变化及临床意义.方法 根据临床表现和冠状动脉造影结果,173例患者分为ST段抬高性心肌梗死（ST-segment elevation myocardial infarction,STEMI）组（n=61）、非ST段抬高急性冠脉综合征（non-ST-segment elevation acute coronary syndrome,NSTE-ACS）组（n=29）、稳定型心绞痛（stable angina pectoris,SAP）组（n=41）、冠状动脉造影正常组（正常对照组,n=42）.酶联免疫吸附试验（ELISA）法测定血清uPA的质量浓度;免疫速率法检测血清高敏C反应蛋白（high-sensitivity Creaction protein,hs-CRP）的质量浓度.结果 （1）STEMI组、NSTE-ACS组、SAP组血清uPA质量浓度均高于正常对照组,差异有统计学意义（P＜0.05或P＜0.01）;STEMI组和NSTE-ACS组血清uPA质量浓度高于SAP组,差异有统计学意义（P＜0.05或P＜0.01）.（2）各组uPA表达特征与hs-CRP的表达特征一致.（3）相关性分析显示,STEMI组、NSTE-ACS组和SAP组血清uPA质量浓度与血清hs-CRP浓度呈正相关（r=0.347,P＜0.01;r=0.452,P＜0.01;r=0.172,P＜0.05）.结论 冠心病患者uPA活性增高,是严重冠状动脉病变的相关危险因素,在冠心病发生、发展中可能起着重要作用.

Changes and clinical significance of urokinase-type plasminogen activator in patients with coronary heart disease

Objectives To investigate the changes and clinical significance of urokinase-type plasminogen activator （uPA）in patients with coronary heart disease （CHD）. Methods Totally 173 patients were classified into 4 groups according to results of coronary angiography （CAG） and clinical data： ST-segment elevation myocardial infarction （STEMI） group （n=61 ）, non-ST-segment elevation acute coronary syndrome （NSTE-ACS） group （n=29）, stable angina pectoris （SAP） group （n=41） and normal control group （n=42）. Serum concentration of uPA was measured by enzyme- linked immunosorbent assay （ELISA）. Serum concentration of high-sensitivity C-reactive protein （hs-CRP） was measured by immune velocity method. Results （ 1 ） Serum concentrations of uPA in SAP group, STEMI group and NSTE-ACS group were significantly higher than that in normal control group （P〈0.05 or P〈0.01 ）. Serum concentrations of uPA in STEMI group and NSTE-ACS group were obviously higher than that in SAP group （P〈0.05 or P〈0.01 ）. （2）The expression characteristic of uPA was consistent with that of hs-CRP in each group. （3）Serum concentrations of uPA in STEMI group, NSTE-ACS group and SAP group had positive correlations with serum concentration of hs-CRP （r=0.347 ,P〈0.01 ; r=0.452, P〈0.01;r=0.172,P〈0.05）. Conclusions The increase of uPA activity is a relative risk factor of severe coronary disease in patients with CHD, which plays an important role in the occurrence and development of CHD.