vWF和EPCR检测在AMI中的临床意义

目的：观察急性心肌梗死（Acute Myocardial Infarction,AMI）患者循环内皮细胞（CEC）核DNA改变的特点,检测血浆中血管性血友病因子（Von Willebr and factor,vWF）、内皮细胞蛋白C受体（vascular endothelial cell protein C receptor,EPCR）的含量变化,探讨其临床意义。方法：应用单细胞凝胶电泳技术（SCGE）检测102例AMI组患者和75例健康对照组CEC核DNA的损伤;以酶联免疫吸附试验（ELISA）进一步检测两组vWF、EPCR的含量。结果：SCGE显示,AMI组患者93.72%±6.75%CEC核DNA电泳呈明显的＂彗星＂状,其彗尾DNA%含量为42.22%±1.56%;对照组10.24%±4.33% CEC核DNA表现为＂彗星＂状,其彗尾DNA%含量为6.31%±2.41%。AMI组与对照组彗星率、彗尾DNA%含量相比均有显著性差异（P〈0.001）。AMI组vWF、EPCR的含量显著高于对照组（P〈0.01）。结论：AMI组患者血管内皮细胞明显损伤;血浆中vWF、EPCR的含量明显升高,早期检测血浆vWF、EPCR的含量可能有利于AMI的治疗,甚至预防。

Clinical Significance of Determination of Plasma VWF and EPCR Contents in Patients with Acute Myocardial Infarction

Objective To study the clinical significance of alterations of circulating endothelial cell （CEC） nuclear DNA and changes of plasma von willebrand factor （vWF） and vascular endothelial cell protein C receptor （EPCR） contents in patients with acute myocardial infarction （AMI）. Methods The fluroscence image of CEC （with single cell gel electrophoresis, SCGE） and plasma contents of vWF and EPCR （with ELISA） were examined in 102 patients with AMI and 75 controls. Results The SCGE showed that in the AMI patients, 93.72%±6.75% of the images were of ＂comet＂ shape, the DNA contents of the comet tail were 42.22%±1.56%. Corresponding figures in the controls were 10.24%±4.33% and 6.31%±2.41% respectively （both P〈0.001）. The plasma contents of vWF and EPCR were significantly higher than those in the controls （P〈0.01）. Conclusion Vascular endothelial cell damage was remarkable in AMI patients with higher plasma contents of vWF and EPCR. Determination of these parameters might be of diagnostic and prognostic importance.