冠心病患者血浆血管性血友病因子、可溶性 E-选择素的变化及意义

目的：检测冠心病患者血浆血管性血友病因子（von Willebrand factor, vWF）及可溶性E-选择素（soluble E-selectin, sE-selectin）的变化，探讨其在冠心病发病机制、病情诊治及监测中的意义。方法：用酶联免疫的方法（ELISA法）测定60例冠心病患者血浆vWF及sE-选择素的水平，并选取20例体检者作为对照；通过病史询问及调查获取实验组冠心病危险因素的资料，进一步分析其与冠心病的关系。结果：冠心病组的血浆vWF及sE-选择素水平明显高于对照组（P=0.017及P<0.001）。急性心肌梗死（AMI）组vWF水平与稳定型心绞痛（SA）组及不稳定型心绞痛(UA)组差异均无统计学意义（P=0.210及P=0.194），而SA组比UA组有明显升高（P=0.012）。sE-选择素水平则AMI组及UA组高于SA组（P<0.001及P=0.010），SA组与对照组无明显差异（P=0.284）。AMI组与UA组无明显差异（P=0.066）。性别、血浆vWF及sE-选择素水平是冠心病的危险因素。结论：血浆vWF及sE-选择素水平是冠心病的危险因子，可能参与了冠心病的发病过程。sE-选择素在不同类型冠心病患者有不同程度的增加，提示sE-选择素可能与冠心病的严重程度有关，可以作为临床监测冠心病病情严重程度的指标。

Changes of plasma von Willebrond factor and soluble E-selectin levels in patients with coronary artery disease

Objective To observe the changes of plasma von Willebrand factor (vWF) and soluble E-selectin (sE-selectin) in patients with coronary artery disease (CAD) and evaluate their clinic significance. Methods The level of plasma vWF and sE-selectin of 60 cases with coronary artery disease were detected by enzyme-linked immunosorbent assay (ELISA) and 20 healthy persons acted as the control group. Risk factors for coronary artery disease were obtained by asking the medical history and the relation ship was analyzed with coronary artery disease. Results The plasma vWF and sE-selectin levels of CAD patients were significantly higher than those of the control group (P=0.017 and P<0.001). There was no significant difference in plasma vWF levels between the acute myocardial infarction (AMI) group and the unstable angina pectoris (UA) group or the SA group(P=0.210 and P=0.194). The plasma vWF level of the SA group were higher than that of the UA group(P=0.012). The plasma levels of sE-selectin of AMI group, and the UA group were higher than those of the SA group(P<0.001 and (P=)0.010). There were no significant differences between the SA group and the control group(P=(0.284)) and between the AMI group and the UA group(P=0.066). Conclusion The increased plasma vWF or sE-selectin level may be risk factors for CAD and they may be involved in the pathogenesis of CAD. The increase of plasma sE-selectin is correlated to the generation and development of CAD and it is important in the evaluation of clinical severity of CAD.