CAJ | 학술논문

目的观察ST段抬高型心肌梗死患者外周血内皮微粒(CD31 +/CD42b-)的水平,探讨CD31 +/CD42b-内皮微粒与传统心肌损伤指标的相关性.方法随机选取2010年1月至2010年12月经冠状动脉造影证实的冠心病患者44例,其中稳定性心绞痛(SAP)患者22例,ST段抬高型心肌梗死患者22例；同期门诊体检健康的对照组22例进行前瞻性观察研究.应用流式细胞仪检测入院时外周血CD31+/CD42b-内皮微粒的水平,应用生化分析仪检测肌酸激酶(CK)及其同工酶(CK-MB),高敏C反应蛋白(hs-CRP)等；用化学发光仪检测肌钙蛋白I(cTnl).STEMI组每4h检测心肌损伤标志物直至入院后48 h.分析入院时血CD31 +/CD42b-内皮微粒与心肌损伤标志物峰值的关系.结果 STEMI患者外周血CD31+/CD42b-内皮微粒的水平显著高于SAP组、正常对照组(P＜0.01),且SAP组与健康对照组比较差异无统计学意义(P＞0.05).STEMI患者心肌损伤标志物(CK,CK-MB,cTnI和hs-CRP)与循环血CD31 +/CD42b -的Spearman相关性分析结果分别为:r=0.489,P=0.021；r=0.501,P=0.018;r =0.491,P=0.02;r =0.612,P=0.002.结论外周血CD31+/CD42b-内皮微粒的水平有可能成为预测STEMI患者心肌损伤的指标.
목적 관찰ST단태고형심기경사환자외주혈내피미립(CD31 +/CD42b-)적수평,탐토CD31 +/CD42b-내피미립여전통심기손상지표적상관성.방법 수궤선취2010년1월지2010년12월경관상동맥조영증실적관심병환자44례,기중은정성심교통(SAP)환자22례,ST단태고형심기경사환자22례；동기문진체검건강적대조조22례진행전첨성관찰연구.응용류식세포의검측입원시외주혈CD31+/CD42b-내피미립적수평,응용생화분석의검측기산격매(CK)급기동공매(CK-MB),고민C반응단백(hs-CRP)등；용화학발광의검측기개단백I(cTnl).STEMI조매4h검측심기손상표지물직지입원후48 h.분석입원시혈CD31 +/CD42b-내피미립여심기손상표지물봉치적관계.결과 STEMI환자외주혈CD31+/CD42b-내피미립적수평현저고우SAP조、정상대조조(P＜0.01),차SAP조여건강대조조비교차이무통계학의의(P＞0.05).STEMI환자심기손상표지물(CK,CK-MB,cTnI화hs-CRP)여순배혈CD31 +/CD42b -적Spearman상관성분석결과분별위:r=0.489,P=0.021；r=0.501,P=0.018;r =0.491,P=0.02;r =0.612,P=0.002.결론 외주혈CD31+/CD42b-내피미립적수평유가능성위예측STEMI환자심기손상적지표.
Objective To observe the level of circulating CD31 +/CD42b-endothelial microparticles in patients with ST-elevated myocardial infarction (STEMI),and discuss the correlation between CD31 +/CD42b-and traditional myocardial injury index.Methods A total of 22 healthy subjects and 44 patients with angiographically confirmed coronary atherosclerotic lesions collected from January 2010 to December 2010 were studied prospectively.The patients were divided into SAP (stable angina pectoris,Canadian Cardiovascular Society,CCS Ⅱ to Ⅲ ) group (n =22) and STEMI group (n =22).The level of circulating CD31 +/CD42b-endothelial microparticles was detected by flow cytometric device after admission; creatine kinase (CK) and its isoenzymes (CK-MB) were detected by using biochemical analyzer; C-reactive protein was determined by a highly sensitive latex-enhanced turbidimetric immunoassay with a low detection limit of 0.25 mg/dl (IMMAGE,Beckman Coulter; Reagent from Orion Diagn Co.Ltd.,Vantaa,Finland).Cardiac troponin I was measured by chemiluminescence immunoassay (ACCESS2 from Beckman Coulter).In 22 STEMI patients,blood sample was taken not only after admission but subsequently at 4-hour intervals during the first 48 hours.Peak levels of myocardial enzymes after injury ( creatine kinase,CK; creatine kinase MB isoenzyme,CK-MB; c troponins I,cTnI) and high sensitive C reactive protein (hs-CRP) values were determined.The correlation between circulating level of CD31 +/CD42b(-) and peak levels of myocardial biomarkers after injury were analyzed.Results The endothelial micro-particles were significantly higher in STEMI patients than those in either SAP group or normal group ( P ＜ 0.01 ),whereas there was no difference between the latter two groups.In STEMI patients studied in these cross sectional study,circulating CD31 +/CD42b-microparticles were positively correlated with peak level of myocardial biomarkers after injury.Moreover,the correlations between myocardial biomarkers after injury ( CK,CK-MB,cTnl and hs-CRP) and circulating CD31 +/CD42b-microparticles were r =0.489,P =0.021; r =0.501,P=0.018; r=0.491,P=0.02; r=0.612,P=0.002.Conclusions The level of circulating blood CD31 +/CD42b-endothelial micro-particle was expected to become a predictive marker in STEMI.