冠心病患者内皮素水平的变化及其与冠脉病变的关系

目的：探讨冠心病患者血浆内皮素（ET）水平变化与冠状动脉病变的关系.方法：选择2012年12月至2013年12月在我院心内科住院确诊的冠心病患者130例,其中稳定型心绞痛（SAP）、不稳定型心绞痛（UAP）各40例,非ST段抬高型心肌梗死（NSTEMI）、ST段抬高型心肌梗死（STEMI）各25例;多支血管病变58例,单支病变72例.冠状动脉造影正常者50名为非冠心病正常对照组.检测各组ET浓度并进行比较分析.结果：（1）冠心病各组血浆ET水平均显著高于非冠心病对照组（P均＜0.01）;STEMI组、NSTEMI组血浆ET水平显著高于UAP组和SAP组（95.6±14.7） pg/ml、（89.6±11.2） pg/ml比（67.2±8.5） pg/ml比（35.7±5.8） pg/m门,且UAP组显著高于SAP组（P均＜0.01）,STEMI组和NSTEMI两组间比较无显著差异（P＞0.05）;（2）冠心病组中多支血管病变组血浆ET水平显著高于单支血管病变组（81.3±12.6） pg/ml比（64.5±10.3） pg/ml],P＜0.01.结论：冠心病患者血内皮素水平显著升高,其检测对于观察病情、判断预后有重要临床意义.

Relationship between change of endothelin level and coronary disease in patients with coronary heart disease

Objective： To explore the relationship between change of plasma endothelin （ET） level and coronary artery dis- ease in patients with coronary heart disease （CHD）. Methods： A total of 130 CHD patients, who were diagnosed from Dec 2102 to Dec 2013, were selected, including 40 patients with stable angina pectoris （SAP）, 40 patients with unstable angina pectoris （UAP）, 25 patients with non ST-segment elevation myocardial infarction （NSTEMI） and 25 patients with ST-seg- ment elevation myocardial infarction （STEMI） ; there were 58 cases with multi-vessel coronary disease and 72 cases with single vessel coronary disease. Another 50 cases with negative coronary angiography results were regarded as non-CHD con- trol group. ET concentration was measured, compared and analyzed among all groups. Results： （1） Plasma ET levels in all CHD group were significantly higher than that of non-CHD control group （P〈0. 01 all）; plasma ET levels of STEMI group and NSTEMI group were significantly higher than those of UAP group and SAP group （95.6 ± 14. 7） pg/ml, （89.6 ± 11.2） pg/ml vs. （67. 2 ± 8. 5） pg/ml vs. （35. 7 ± 5. 8） pg/ml], and that of UAP group was significantly higher than that of SAP group （P〈0. 01 all）, there was no significant difference between STEMI group and NSTEMI group （P 0. 05） ; （2） In CHD group, plasma ET level in multi-vessel coronary disease group was significantly higher than that of sin- gle-vessel coronary disease group （81.3 ± 12.6） pg/ml vs. （64. 5 ± 10. 3） pg/ml], P〈0. 01. Conclusion： Plasma endothe- lin level significantly rises in patients with coronary heart disease, its detection is of important significance for observing pa- tient＇s condition and judging prognosis.