急性冠状动脉综合征患者冠状动脉循环粘附分子的变化

目的探讨急性冠状动脉综合征患者冠状动脉循环血浆细胞间粘附分子1和血管细胞粘附分子1水平变化的临床意义.方法应用酶联免疫吸附法检测65例冠心病患者(30例急性冠状动脉综合征,35例稳定型心绞痛)及27例对照者冠状动脉循环(冠状静脉窦-主动脉根部)血浆细胞间粘附分子1和血管细胞粘附分子1水平,比较其水平变化与不同冠心病类型之间的关系.结果急性冠状动脉综合征组冠状静脉窦和主动脉根部血浆细胞间粘附分子l和血管细胞粘附分子1水平明显高于稳定型心绞痛组和对照组(P＜0.05);急性冠状动脉综合征组冠状动脉循环(冠状静脉窦与主动脉根部的差值)血浆细胞间粘附分子1和血管细胞粘附分子1水平明显高于稳定型心绞痛组和对照组(P＜0.01).稳定型心绞痛组和对照组冠状静脉窦、主动脉根部和冠状动脉循环血浆细胞间粘附分子1和血管细胞粘附分子1水平无明显差别(P＞0.05).血浆细胞间粘附分子1和血管细胞粘附分子1水平与冠状动脉病变受累支数无关.结论急性冠状动脉综合征时血浆细胞间粘附分子1和血管细胞粘附分子1浓度显著升高,冠状动脉循环血浆细胞间粘附分子1和血管细胞粘附分子1变化反映冠状动脉炎症活动程度,细胞粘附分子参与斑块的不稳定.

Changes of Plasma Adhesion Molecule Levels of Coronary Circulation in Patient with Acute Coronary Syndrome

Aim To study clinical relationship of plasma adhesion molecule levels of coronary circulation in patients with acute coronary syndrome (ACS). Methods The plasma intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) levels in the coronary sinus and aortic root were simultaneously examined in 30 patients with ACS, 35 patients with stable angina pectoris (SA) and 27 patients with control subjects. The plasma levels of ICAM-1 and VCAM-1 were measured by enzyme-linked immunosorbent assay. Results Both in the aortic root and the coronary sinus, the plasma ICAM-1 and VCAM-1 levels were significantly higher (P<0.05) in patients with ACS than in those with SA and in control subjects. The different plasma levels of adhesion molecules between coronary sinus and aortic root were significantly higher (P< 0.001) in patients with ACS than in those with SA and in control subjects. There were no significant differences in the values between in the coronary sinus and aortic root in patients with SA and control subjects. There were no significant relationship between plasma ICAM-1 and VCAM-1 levels and coronary lesion degree. Conclusions The plasma ICAM-1 and VCAM-1 levels were significantly higher in ACS. The changes of plasma ICAM-1 and VCAM-1 levels in coronary circulation reflect the severity of inflammation of coronary artery and may be related to plaque unstablity.