血管痉挛性心绞痛患者嗜酸性粒细胞计数及纤维蛋白原测定的临床意义

目的研究血管痉挛性心绞痛(VAP)患者嗜酸性粒细胞(EOS)计数和血浆纤维蛋白原(Fbg)水平的变化。方法收集疑为冠状动脉疾病(CAD)或电生理研究提示心律失常而行诊断性心导管术的住院患者共93例,根据相关诊断标准将其分3组,VAP患者39例,稳定性心绞痛(SAP)患者35例,对照组19例。再根据临床症状的严重度,将VAP组分为轻度VAP组(22例)和重度VAP组(17例)。采集血样分别测定各组患者的WBC计数及分类计数、Fbg、C反应蛋白(CRP)。结果除SAP组高密度脂蛋白胆固醇(HDLC)明显低于对照组外(P<0.01),其他冠心病危险因子、体温、WBC总数、CRP等在VAP、SAP及对照组间无统计学意义(P>0.05)。而重度VAP组EOS计数、血浆Fbg均明显高于其他3组(P<0.01,P<0.05)。VAP患者经药物治疗后,EOS计数明显低于治疗前(P<0.01)。结论EOS计数和血浆Fbg水平可预示VAP患者病情严重度,提示冠状动脉痉挛可能引致EOS和Fbg水平升高。

Clinical significance of determination of eosinophil counts and fibrinogen in patients with vasospasm angina pectoris

Objective To study the change of eosinophil counts and plasm fibrinogen levels in patients with vasospasm angina pectoris (VAP).Methods All subjects (93 cases) were selected from patients who were hospitalized for diagnostic catheterization because of suspected coronary artery disease or for the electrophysiologic study of arrhythmia.These patients were divided into 3 groups according to the criteria of diagnosis.The VAP group (39 cases) who had spontaneous angina attacks,the stable angina pectoris (SAP) group (35 cases) and control group (19 cases).Patients with VAP were further divided into mild VAP group (22 cases) and severe VAP group(17 cases) based on the severity of symptoms.Fasting vein blood were collected for differential and white blood cells (WBC) counts,fibrinogen (Fbg) and C-reactive protein (CRP).Results There were no significant differences among the control,VAP,SAP groups,except for the HDL-C levels in the SAP group were significantly lower than those in the control group(P<0.01).In addition,the CRP levels ,WBC,red blood cells(RBC)and platelet (PLT) counts did not differ among the 4 groups(P>0.05).In contrast, there was significant increase in the eosinophil counts in the severe VAP group compared with the other 3 groups(P<0.01),the plasma fibrinogen levels were significantly higher in the severe VAP group than those in the other 3 groups(P<0.05). The eosinophil counts after medical therapy in patients with VAP were reduced significantly to the same levels as those in the control group(P<0.01).Conclusion The eosinophil counts and plasma fibrinogen levels could predict the severity of VAP.This study suggests that coronary vasospasm could result in increase in eosinophil counts and plasma fibrinogen levels.