内皮素与P-选择素在冠心病中的意义

目的研究内皮素 (endothelin 1,ET 1)、P 选择素和肌钙蛋白I(CTnI)在急性心肌梗死 (acutemyocardialinfarction ,AMI)和不稳定性心绞痛 (unstableangina ,UA)中的意义。 方法用放射免疫法测定ET 1,流式细胞仪测定P 选择素 ,Access化学发光法测定CTnI ,共检测 2 3例AMI患者 ,2 1例UA患者及 2 8例健康对照者。结果AMI组的ET 1、P 选择素和CTnI值均明显高于对照组 (P <0 .0 5— 0 .0 1) ;UA组的ET 1、P 选择素高于对照组 (P <0 .0 5 ) ;UA组的CTnI与对照组无显著性差异 (P >0 .0 5 ) ;UA组的P 选择素、CTnI低于AMI组 (P <0 .0 5 )。多元回归分析发现P 选择素与CTnI相关 ,相关系数r =0 .40 4,(P <0 .0 1)。结论ET 1、P 选择素是检测血栓前状态的敏感指标。

Clinical significance of endothelin-1 and P-selection in coronary heart disease

ObjectiveTo explored the relationship among endothelin 1(ET 1), P selection and troponin I(CTnI) in acute myocardial infarction (AMI) and unstable angina (UA).MethodsPlasma level of endothelin 1 was analyzed by radioimmunoassay, the expression of P selection was analyzed by flow cytometery technique and troponin I was analyzed by paramagnetic partile chemiluminescent immunoassay in 23 AMI cases, 21 UA cases and 28 healthy controls.ResultsPlasma levels of ET 1 and CTnI in AMI patients were higher than in controls( P<0.05). The expression of P selection in AMI patients was higher than in controls ( P< 0.01 ). Plasma levels of ET 1 and expression of P selection in UA patients were higher than in controls ( P<0.05). There was an increased trend of CTnI in UA patients in contrast to controls, but without statistical significance( P>0.05). As compared with UA , plasma levels of CTnI and expression of P selection were elevated in AMI patients ( P<0.05). No significant difference was observed between AMI and UA cases in plasma level of ET 1. Multivariate regression analysis revealed that P selection was significantly associated with AMI and UA cases compared with plasma level of CTnI (r=0.404, P<0.01).ConclusionsPlasma levels of ET 1 and P selection were sensitive markers as prethrombolic status.