血清缺氧诱导因子1α及血管内皮生长因子水平与急性冠状动脉综合征的关系

目的研究冠心病（CHD）患者血清低氧诱导因子1α（HIF-1α）、血管内皮生长因子（VEGF）水平变化的意义及其与冠状动脉病变支数和狭窄程度的关系。方法选择79例CHD患者，分为急性冠状动脉综合征（ACS）组42例，其中急性心肌梗死（AMI）组23例，不稳定型心绞痛（UAP）组19例；稳定型心绞痛（SAP）组37例；另选35例作为健康对照组。应用酶联免疫吸附测定法测定所有患者HIF_1a、VEGF水平。结果AMI组、UAP组HIF-1α和VEOF水平明显高于SAP组和对照组，HIF-1α（117．6±28．6）pg／L、（110．2±17．1）pg／L vs （49．9士20．5）pg／L、（43．1±16．3）pg／L，VEGF（215．0±51．5）ng／L、（194．4±38．4）ng／L vs （94．3±34．2）ng／L、（90．3±32．9）ng／L（均P〈0．01）；SAP组VEOF、HIF-1α水平与对照组比较差异无统计学意义（P〉0．05）。单支、双支、3支血管病变CHD患者血清HIF-1α、VEGF浓度比较差异无统计学意义（P〉0．05）。AMI组、UAP组、SAP组之间Gensini评分差异无统计学意义（P〉0．05）。血清HIF-1α、VEGF浓度与Gensini评分之间无相关性。结论HIF-1α、VEOF水平与冠状动脉病变的支数和狭窄程度无关，而与动脉粥样硬化斑块失稳定有关，可能是斑块的不稳定的标志。

Relation between serum hypoxia inducible faetor-1a and vascular endothelial growth factor with acute coronary syndrome

Objective To study the serum level of hypoxia-inducible faetor-la（HIF-1α） and vascular endothelial growth factor（VEGF） in the patients with coronary heart disease（CHD）, for the clinical significance and the correlation beween the serum level of HIF-1α and VEGF with the number of diseased vessels and the severity of coronary artery stenosis. Methods 79 patients with CHD were chosen and divided into two groups., acute coronary syndrome（ACS） group,42 cases,stable angina pectoris（SAP） group, 37 cases. While ACS group included 19 patients with unstable angina pectoris（UAP）, 23 patients with acute myocardial infarction（AMI）. In addition, 35 healthy cases were chosen as health control group. The serum level of HIF-1α, VEGF in all cases were tested by enzyme linked immunosorbent assay （ELISA）. Results The serum levels of HIF-1α and VEGF in AMI and UAP group were higher than those in SAP group and control group,HIF-1α（117. 6±28.6） pg/L,（110.2±17.1） pg/L vs （49.9±20.5） pg/L, （43.1±16.3） pg/L; VEGF（215. 0±51. 5） ng/L,（194.4±38.4） ng/L vs （94.3±34.2） ng/L, （90.3±32.9） ng/L（all P〈0.01）. There was no difference in HIF-1α and VEGF between SAP group and control group （P〉0.05）;there was no difference among 1 branch,2 branches, 3 branches of diseased vessels （ P〉0.05）;also no difference in Gensini score between AMI or UAP group and SAP group（ P〉0.05） ,and the serum level of HIF-1α and VEGF had no correlation with Gensini score. Conclusion The serum levels of HIF-1α and VEGF in the patients with CHD have no correlation with the number of diseased vessels or Gensini score,but correlation with atherosclerotic plaque destabilization. The elevation of HIF-1α,VEGF may be a sign of atherosclerotic plaque destabilization.