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目的:观察冠心病患者血浆中单核细胞趋化蛋白-1(MCP-1)的浓度,探讨其诊断冠心病的意义及临床价值。方法:将122例患者分为非冠心病组(30例)、稳定型心绞痛组(32例)、不稳定型心绞痛组(27例)和急性心肌梗死组(33例),应用酶联免疫吸附法检测患者血浆中MCP-1、组织因子(TF)的浓度。结果:①血浆中MCP-1、TF的浓度均为:非冠心病组<稳定型心绞痛组<不稳定型心绞痛组<急性心肌梗死组(均P<0.05)。②血浆中MCP-1的浓度与患者的性别、吸烟、冠心病家族史、高血压和糖尿病、TG、HDL-C、尿素氮、肌酐无明显相关性(均P>0.05),与年龄、体质指数、TC、LDL-C、尿酸、心肌肌钙蛋白I、肌酸激酶同工酶、TF呈正相关性(均P<0.05)。③以血浆中MCP-1的浓度作为诊断急性冠状动脉综合征的指标,ROC曲线分析结果显示MCP-1的诊断价值较大,曲线下面积0.939(P<0.05),最佳临界值为320.5ng/L,其特异度和灵敏度分别是86.7%和88.0%。结论:血浆中MCP-1在判断冠状动脉粥样硬化斑块易损性方面有一定的临床意义,可能是冠心病的一个独立危险因素,可作为诊断急性冠状动脉综合征的理想指标。
Objective: To observe the concentration of monocyte chemoattractant protein-1 (MCP-1) in plasma of patients with coronary heart disease (CHD), and to explore its significance and clinical value in the diagnosis of coronary heart disease. Methods: 122 patients were divided into non-coronary heart disease group (30 cases), stable angina group (32 cases), unstable angina group (27 cases) and acute myocardial infarction group (33 cases) Methods Plasma concentrations of MCP-1 and tissue factor (TF) were measured. Results: ① The concentrations of MCP-1 and TF in plasma were non-coronary heart disease group (unstable angina pectoris group, unstable angina pectoris group, acute myocardial infarction group, all P <0.05). ② The plasma concentration of MCP-1 had no significant correlation with gender, smoking, family history of coronary heart disease, hypertension and diabetes, TG, HDL-C, urea nitrogen and creatinine (all P> 0.05) The indexes, TC, LDL-C, uric acid, cardiac troponin I, creatine kinase isoenzyme and TF were positively correlated (all P <0.05). The plasma concentration of MCP-1 as an index for the diagnosis of acute coronary syndromes, ROC curve analysis showed that the value of MCP-1 diagnosis, the area under the curve 0.939 (P <0.05), the best cut-off value of 320.5ng / L, the specificity and sensitivity were 86.7% and 88.0% respectively. CONCLUSION: MCP-1 in plasma has certain clinical significance in assessing the vulnerability of coronary atherosclerotic plaque. It may be an independent risk factor for coronary heart disease and may be an ideal indicator for the diagnosis of acute coronary syndrome.