中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
4期
10-13
,共4页
冠状动脉硬化%血管造影术%胎盘生长因子
冠狀動脈硬化%血管造影術%胎盤生長因子
관상동맥경화%혈관조영술%태반생장인자
Coronary arteriosclerosis%Angiograph%Placental growth factor
目的 探讨血清胎盘生长因子(PLGF)在急性冠状动脉综合征(ACS)临床诊断策略中的意义.方法 112例行冠状动脉造影患者根据临床资料和造影结果分为非冠心病(non-CAD)组27例、稳定型心绞痛(SA)组28例、不稳定型心绞痛(UA)组29例、急性心肌梗死(AMI)组28例.其中57例ACS患者按冠状动脉造影结果分为单支病变组19例、双支病变组16例、三支病变组22例,并根据Jenkins积分分为0～7分组23例、8～ 15分组27例、16～32分组7例.分别检测各组入院时血清PLGF水平,并进行比较.40例患者接受经皮冠状动脉介入治疗(PCI),分别检测术前30min、术后第1天、术后第2天血清PLGF水平.结果 AMI组血清PLGF水平为(38.33±10.14)ng/L,UA组血清PLGF水平为(37.44±13.32) ng/L,均显著高于SA组的(20.90±3.88) ng/L及non-CAD组的(20.34±4.53) ng/L(P＜ 0.01)；AMI组与UA组、SA组与non-CAD组血清PLGF水平比较差异无统计学意义(P＞0.05).三支病变组、双支病变组、单支病变组血清PLGF水平两两比较差异均无统计学意义(P＞ 0.05)；Jenkins积分0～7分组、8～ 15分组、16～32分组血清PLGF水平两两比较差异均无统计学意义(P＞0.05).40例接受PCI的患者术后第1天血清PLGF水平为(32.03±7.41) ng/L,显著高于术前的( 23.86±6.91) ng/L(P＜ 0.05),术后第2天血清PLGF水平[(29.37±6.99) ng/L]较术后第1天呈回落趋势(P＞0.05).经Pearson相关分析,AMI患者血清PLGF水平与心肌肌钙蛋白T及肌酸激酶同工酶-MB水平无显著相关性(r=-0.158,P=0.421；r=0.302,P=0.118).结论 血清PLGF水平是反映ACS患者冠状动脉粥样硬化斑块失稳定或斑块破裂的一个炎性标志物,对ACS疑似病例的早期诊断有一定的参考价值.
目的 探討血清胎盤生長因子(PLGF)在急性冠狀動脈綜閤徵(ACS)臨床診斷策略中的意義.方法 112例行冠狀動脈造影患者根據臨床資料和造影結果分為非冠心病(non-CAD)組27例、穩定型心絞痛(SA)組28例、不穩定型心絞痛(UA)組29例、急性心肌梗死(AMI)組28例.其中57例ACS患者按冠狀動脈造影結果分為單支病變組19例、雙支病變組16例、三支病變組22例,併根據Jenkins積分分為0～7分組23例、8～ 15分組27例、16～32分組7例.分彆檢測各組入院時血清PLGF水平,併進行比較.40例患者接受經皮冠狀動脈介入治療(PCI),分彆檢測術前30min、術後第1天、術後第2天血清PLGF水平.結果 AMI組血清PLGF水平為(38.33±10.14)ng/L,UA組血清PLGF水平為(37.44±13.32) ng/L,均顯著高于SA組的(20.90±3.88) ng/L及non-CAD組的(20.34±4.53) ng/L(P＜ 0.01)；AMI組與UA組、SA組與non-CAD組血清PLGF水平比較差異無統計學意義(P＞0.05).三支病變組、雙支病變組、單支病變組血清PLGF水平兩兩比較差異均無統計學意義(P＞ 0.05)；Jenkins積分0～7分組、8～ 15分組、16～32分組血清PLGF水平兩兩比較差異均無統計學意義(P＞0.05).40例接受PCI的患者術後第1天血清PLGF水平為(32.03±7.41) ng/L,顯著高于術前的( 23.86±6.91) ng/L(P＜ 0.05),術後第2天血清PLGF水平[(29.37±6.99) ng/L]較術後第1天呈迴落趨勢(P＞0.05).經Pearson相關分析,AMI患者血清PLGF水平與心肌肌鈣蛋白T及肌痠激酶同工酶-MB水平無顯著相關性(r=-0.158,P=0.421；r=0.302,P=0.118).結論 血清PLGF水平是反映ACS患者冠狀動脈粥樣硬化斑塊失穩定或斑塊破裂的一箇炎性標誌物,對ACS疑似病例的早期診斷有一定的參攷價值.
목적 탐토혈청태반생장인자(PLGF)재급성관상동맥종합정(ACS)림상진단책략중적의의.방법 112례행관상동맥조영환자근거림상자료화조영결과분위비관심병(non-CAD)조27례、은정형심교통(SA)조28례、불은정형심교통(UA)조29례、급성심기경사(AMI)조28례.기중57례ACS환자안관상동맥조영결과분위단지병변조19례、쌍지병변조16례、삼지병변조22례,병근거Jenkins적분분위0～7분조23례、8～ 15분조27례、16～32분조7례.분별검측각조입원시혈청PLGF수평,병진행비교.40례환자접수경피관상동맥개입치료(PCI),분별검측술전30min、술후제1천、술후제2천혈청PLGF수평.결과 AMI조혈청PLGF수평위(38.33±10.14)ng/L,UA조혈청PLGF수평위(37.44±13.32) ng/L,균현저고우SA조적(20.90±3.88) ng/L급non-CAD조적(20.34±4.53) ng/L(P＜ 0.01)；AMI조여UA조、SA조여non-CAD조혈청PLGF수평비교차이무통계학의의(P＞0.05).삼지병변조、쌍지병변조、단지병변조혈청PLGF수평량량비교차이균무통계학의의(P＞ 0.05)；Jenkins적분0～7분조、8～ 15분조、16～32분조혈청PLGF수평량량비교차이균무통계학의의(P＞0.05).40례접수PCI적환자술후제1천혈청PLGF수평위(32.03±7.41) ng/L,현저고우술전적( 23.86±6.91) ng/L(P＜ 0.05),술후제2천혈청PLGF수평[(29.37±6.99) ng/L]교술후제1천정회락추세(P＞0.05).경Pearson상관분석,AMI환자혈청PLGF수평여심기기개단백T급기산격매동공매-MB수평무현저상관성(r=-0.158,P=0.421；r=0.302,P=0.118).결론 혈청PLGF수평시반영ACS환자관상동맥죽양경화반괴실은정혹반괴파렬적일개염성표지물,대ACS의사병례적조기진단유일정적삼고개치.
Objective To explore the changes of placental growth factor (PLGF) in patients with acute coronary syndrome (ACS).Methods One hundred and twelve patients were divided into four groups according to clinical data and coronary angiography:non-coronary artery disease (non-CAD) group (27 cases),stable angina (SA) group (28 cases ),unstable angina (UA) group (29 cases) and acute myocardial infarction (AMI) group (28 cases).Fifty-seven patients with ACS were divided into single lesion group (19 cases),twice lesion group ( 16 cases) and triple lesion group (22 cases) by coronary angiography,and 0-7 scores group (23 cases),8-15 scores group (27 cases) and 16-32 scores group (7 cases) by Jenkins scores.The serum PLGF levels of all the cases were determined on admission.The serum PLGF levels of 40 cases receiving percutaneous coronary intervention (PCI) were determined at 30 min before operation,the first and second day after operation.Results The serum PLGF levels of AMI group and UA group were (38.33 ±10.14) ng/L and (37.44 ± 13.32) ng/L respectively,which were significant higher than that of SA group [(20.90 ± 3.88) ng/L] and non-CAD group [(20.34 ±4.53) ng/L](P＜ 0.01),and there was no significant difference between AMI group and UA group,SA group and non-CAD group (P ＞0.05).There was no significant difference in the serum PLGF level among triple lesion group,twice lesion group and single lesion group (P ＞ 0.05 ).There was no significant difference in the serum PLGF level among 0-7 scores group,8-15scores group and 16-32 scores group (P ＞ 0.05).The serum PLGF level of patients receiving PCI on the first day after operation [ (32.03 ± 7.41 ) ng/L] was significantly higher than that before operation [ (23.86 ± 6.91 ) ng/L](P＜ 0.05 ),and on the second day after operation the serum PLGF level [ (29.37 ± 6.99) ng/L] was less than that on the first day after operation,showing a fall tendency(P＞ 0.05).Pearson correlation analysis showed that the serum PLGF levels in patients with ACS were not related with cardiac troponin T and creatine kinase isozyme-MB (r =-0.158,P=0.421;r =0.302,P=0.118).Conclusion The serum PLGF level of ACS patients is an inflammatory marker reflecting coronary atherosclerotic plaque destabilizing or plaque ruptured,and may also play an important role in early diagnosis of the borderline case of ACS.
