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目的:检测主动脉夹层(AD)和急性冠脉综合征(ACS)患者外周血含Ⅰ型血小板结合蛋白基序(TSP)的解聚蛋白样金属蛋白酶-9(ADAMTS-9)水平,以探索是否能将ADAMTS-9用于AD的鉴别诊断。方法:选择51例确诊AD患者、84例急性ST段抬高心肌梗死(STEMI)患者、41例急性非ST段抬高心肌梗死(NSTEMI)患者、65例不稳定性心绞痛(UAP)患者,采集其临床资料,取外周血离心、分离血浆,使用ELISA法检测血浆ADAMTS-9水平。结果:4组受试者在性别、高血压病史、血肌酐水平、血脂水平、体重指数方面无统计学差异;AD组患者发病年龄、合并糖尿病史患者比例及高敏C反应蛋白水平均与其它3组存在显著性差异(均P<0.05);4组患者血浆ADAMTS-9水平分别为277.51±66.74ng/ml、53.73±60.01ng/ml、51.02±44.21ng/ml、64.19±56.64ng/ml,AD组较ACS组明显升高(P<0.05)。结论:ADAMTS-9可作为鉴别AD和ACS患者的指标之一。
OBJECTIVE: To detect the level of de novo protein-like metalloproteinase-9 (ADAMTS-9) in peripheral blood of patients with aortic dissection (AD) and acute coronary syndrome (ACS) ADAMTS-9 can be used for the differential diagnosis of AD. METHODS: Totally 51 patients with confirmed AD, 84 patients with acute ST-elevation myocardial infarction (STEMI), 41 patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) and 65 patients with unstable angina (UAP) The clinical data, peripheral blood centrifuged, plasma separation, the use of ELISA test plasma ADAMTS-9 levels. Results: There was no significant difference in sex, history of hypertension, serum creatinine, blood lipid and body mass index among the four groups. The age of onset, the proportion of patients with history of diabetes mellitus, and the high-sensitivity C-reactive protein in AD group were similar to those in other 3 The levels of ADAMTS-9 in the four groups were 277.51 ± 66.74ng / ml, 53.73 ± 60.01ng / ml, 51.02 ± 44.21ng / ml and 64.19 ± 56.64ng / ml respectively, all of which were significantly different (all P <0.05) AD group was significantly higher than ACS group (P <0.05). Conclusion: ADAMTS-9 can be used as one of the indicators to distinguish patients with AD and ACS.