急性心肌梗死和不稳定性心绞痛患者粘附分子及相关因素的研究

来源 :中华老年心脑血管病杂志 | 被引量 : 0次 | 上传用户:information1005
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目的 探讨急性心肌梗死 (AMI)和不稳定性心绞痛 (UAP)患者发病早期和 1周可溶性细胞间粘附分子 1(sICAM 1)、可溶性血管细胞粘附分子 1(sVCAM 1)、D 二聚体、血小板第 4因子 (PF4 )的动态变化及其相互关系。方法 测定 40例AMI、45例UAP患者发病 2 4h和 1周时血清sICAM 1、sVCAM 1、D 二聚体、PF4 并与 30例对照组比较。结果 AMI和UAP患者于发病 2 4h和 1周时sICAM 1、sVCAM 1、D 二聚体、PF4 均明显高于对照组 (P<0 0 1)。AMI组中 ,溶栓再通者与未溶栓者sICAM 1、sVCAM 1、D 二聚体、PF4 比较 ,差异无显著性意义 (P>0 0 5 )。AMI溶栓组中再通后与再通前相比 ,sICAM 1、sVCAM 1、D 二聚体均明显下降 (P <0 0 5 ) ;AMI、UAP组于发病 2 4h及 1周时sICAM 1与sVCAM 1均具有正相关性 (P <0 0 1) ,PF4 与sICAM 1、sVCAM 1、D 二聚体间亦具有正相关性 (P <0 0 1)。结论 AMI、UAP从发病早期至 1周sICAM 1、sVCAM 1持续升高 ,以AMI更为明显 ,表明炎症参与心肌细胞损伤过程 Objective To investigate the expression of soluble intercellular adhesion molecule 1 (sICAM 1), soluble vascular cell adhesion molecule 1 (sVCAM 1) and D dimer in the patients with acute myocardial infarction (AMI) and unstable angina pectoris (UAP) , Platelet factor 4 (PF4) dynamic changes and their relationship. Methods Serum levels of sICAM 1, sVCAM 1, D dimer and PF4 in 40 patients with AMI and 45 patients with UAP at 24 hours and 1 week were measured and compared with 30 controls. Results The sICAM 1, sVCAM 1, D dimer and PF4 in AMI and UAP patients were significantly higher than those in control group (P <0.01) at 2 and 4 hours after onset of disease. There was no significant difference between AMI group and sICAM 1, sVCAM 1, D dimer and PF4 without thrombolysis (P> 0.05). Compared with the pre-recanalization group, sICAM 1 and sVCAM 1, D dimers were significantly decreased in the AMI thrombolysis group (P <0.05); in the AMI and UAP groups, sICAM 1 (P <0.01). There was a positive correlation between PF4 and sICAM 1, sVCAM 1, D dimers (P <0.01). Conclusions The AMI and UAP levels of sICAM 1 and sVCAM 1 increased from the early stage to the first week of onset, and were more obvious with AMI, indicating that inflammation is involved in the process of cardiomyocyte injury
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