冠心病患者血清可溶性E-选择素检测的意义

目的　探讨血清可溶性E 选择素在监测冠心病病情及与冠状动脉病变程度的关系。方法　 81例冠心病患者 ,按临床诊断分为 4组 :急性心肌梗死 (AMI) 17例、不稳定性心绞痛 (UAP) 2 4例、稳定性心绞痛 (SAP) 2 0例和对照组患者 2 0例。检测各组患者血清可溶性E 选择素的水平 ,并比较各组间的差异。对冠心病患者的冠状动脉损害行Gensini评分 ,并与其血清可溶性E 选择素水平进行直线相关分析。结果　 (1)AMI组、UAP组及SAP组的血清可溶性E 选择素水平比对照组高 ;(2 )AMI组、UAP组可溶性E 选择素水平和SAP组相比 ,其值增加明显 ;AMI组和UAP组结果相似 ;(3)急性冠脉综合征 (AMI组 +UAP组 )血清可溶性E 选择素水平与冠状动脉Gensini评分呈正相关。结论　血清可溶性 E选择素可能是冠状动脉粥样硬化的标志 ,参与了冠心病的发病过程 ,在急性冠脉综合征中 ,其值与冠状动脉病变程度密切相关。

Significance of soluble E-selectin in patients with coronary artery disease

Objectives To study the relationship of soluble E selectin with the severity of coronary artery disease(CAD) and coronary artery stenosis,and to investigate whether it is a non invasive marker of coronary plaque destabilization in CAD.Methods The 4 study groups included 17 cases of acute myocardial infarction(AMI group)within 14 hours after the onset, 24 cases of unstable angina(UAP group)within 14 hours after the last episode, 20 cases of stable angina(SAP group)and the control group consisting of 12 cases of paroxysmal supraventricular tachycardia and 8 cases of normal coronary artery. Serum level of soluble E selectin was measured by means of enzyme linked immunosorbent assay.The severity of coronary lesion was graded with Gensini Score.The differences of soluble E selectin levels between different groups were observed.Pearson correlation analysis test was used to analyze the relationship between the level of soluble E selectin and Gensini score in CAD.Results (1)The levels of soluble E selectin were elevated in AMI, UAP and SAP groups as compared with the control group.(2)Compared with SAP group, the levels of soluble E selectin were elevated in AMI and UAP groups,while there is no significant difference between AMI and UAP groups.(3) The levels of soluble E selectin were correlated with the extent of coronary atherosclerosis in acute coronary syndrome.Conclusion Soluble E selectin can be used as a marker of the presence of coronary atherosclerosis and is involved in the pathogenesis of CAD.Measurement of it may be helpful for diagnosing coronary plaque destabilization and the severity of CAD.The levels of soluble E selectin correlate with the extent of coronary atherosclerosis in acute coronary syndromes.