胎盘生长因子对评估冠心病患者冠脉病变的价值

目的探讨胎盘生长因子(PLGF)在冠心病患者冠状动脉支架置入术前后中的表达及其对评估冠脉病变严重程度的价值。方法 2010年11月至2011年4月入住本院心血管内科胸痛患者与同期健康体检者,测定其血浆PLGF水平。按冠脉造影结果分为冠心病组与非冠心病组;按是否行冠脉支架置入术把冠心病组分为支架置入组(PCI组)、非支架置入组(非PCI组);按累及冠脉病变血管数把冠心病组分为单支组、双支组、多支组,测定其术前与术后第1天的PLGF水平。结果 1)冠心病组术前PLGF明显高于非冠心病组与对照组,差异有统计学意义(P<0.01);2)术前与术后PLGF水平在PCI组明显高于非PCI组,但均低于各自组术前,P<0.05;3)在术前血浆PLGF水平多支组明显高于单支组与双支组,术后三组PLGF水平均明显低于术前,P<0.05,而术前单支组、双支组之间与术后上述三组各自间差异无统计学意义(P>0.05);4)单支组、双支组、多支组比较,行PCI的PLGF水平均高于非PCI组,P<0.05。结论检测血浆PLGF水平在胸痛的鉴别诊断中具有一定意义,有助于冠心病的早期诊断;需要血运重建的冠状动脉病变PLGF水平明显增高,且通过冠状动脉支架置入术后PLGF水平均明显回落,能初步评估冠脉病变的严重程度。

The Value of Placental Growth Factor to Assess the Coronary Lesion of Patients with Coronary Heart Disease

Objective To investigate the level of plasma placental growth factor(PLGF) in coronary artery disease(CAD) before and after percutaneous coronary angioplasty stent implantation and the value of assessing the extent of coronaries lesion.Methods All subjects were from the inpatients with chest pain in the department of cardiology and normal controls from the medical examination center in the same hospital,during November 2010 and April 2011.Plasma PLGF was detected by ELISA.According to the results of coronary angiography(CAG),the patients were divided into CAD group and Non-CAD group.The CAD group was divided into PCI group and Non-PCI group according to whether having stent implantation or not.The CAD group was divided into the single,double and triple vessel lesions groups by the numbers of vessel lesions in coronary artery.Plasma PLGF was measured before and the day after CAG.Results 1.The plasma PLGF level in CAD group was significantly higher than that in Non-CAD group and control group before CAG(P<0.01);2.The plasma PLGF level in PCI group was higher than that in Non-PCI group both before and after PCI,meanwhile the level of both groups after PCI was lower than that before,P<0.05;3.The plasma PLGF level in triple vessel lesions group was significantly higher than that in single and double groups before CAG(P<0.05),and three groups of them after CAG were significantly lower than that before CAG(P<0.05);but the level of PLGF was not significant difference,neither in single and double vessel lesions groups before CAG,nor in the three groups of them after CAG(P>0.05).Conclusions The plasma PLGF level has differential diagnosis value in patients with chest pain.The measurement of plasma PLGF may be helpful for early diagnosis of coronary artery disease.The patient who needed PCI,their PLGF levels were extremely higher,and would obviously decrease after PCI,the PLGF level may assess the extent of coronary lesion.