CAJ | 학술논문

目的探讨血小板-白细胞聚集体( PLA)与急性冠状动脉综合征(ACS)的相关性.方法入选拟诊冠心病的患者186例,根据相关的诊断标准分为3组,ACS组86例,稳定性心绞痛(SAP)组54例,经冠状动脉造影证实的非冠心病者46例作为对照组.冠状动脉造影前抽取外周静脉血,用流式细胞仪测定所有患者的PLA.比较3组的基线资料,并对3组间PLA、血小板-单核细胞聚集体(PMA)、血小板-中性粒细胞聚集体(PNA)、血小板-淋巴细胞聚集体(PlyA)、高敏C反应蛋白(hs-CRP)值进行比较.在ACS组,根据患者入院时GRACE积分分值,将患者分成2组:低危组(0～108分)30例,高危组(≥109分)56例,比较这两组PLA的差别.利用Spearman相关性分析比较PLA、PMA、PNA、PlyA分别与hs-CRP及GRACE积分的相关性.结果 ACS组的PLA (4.40％±3.08％)、PMA (33.6％±21.5％)、PNA( 3.76％±5.06％)、PLyA(2.03％±1.27％)及hs-CRP[5.75(3.49,9.15)]均高于SAP组和对照组(P均＜0.05).GRACE积分高危组PMA值明显高于低危组(44.8％±18.0％比13.0％±6.3％,P＜0.01).Spearman相关性分析显示,hs-CRP与PMA呈正相关(r =0.547,P＜0.001),与PLA、PNA、PlyA均无相关性.GRACE积分与PMA、PLA、PNA、PlyA均呈正相关(r值分别为0.746、0.652、0.460、0.435,P均＜0.01).结论 PLA升高可能预示着ACS患者的不稳定状态,ACS患者PLA水平明显升高,PLA与hs-CRP及GRACE积分正相关,提示PLA可作为预测ACS患者病情的指标之一.
목적 탐토혈소판-백세포취집체( PLA)여급성관상동맥종합정(ACS)적상관성.방법 입선의진관심병적환자186례,근거상관적진단표준분위3조,ACS조86례,은정성심교통(SAP)조54례,경관상동맥조영증실적비관심병자46례작위대조조.관상동맥조영전추취외주정맥혈,용류식세포의측정소유환자적PLA.비교3조적기선자료,병대3조간PLA、혈소판-단핵세포취집체(PMA)、혈소판-중성립세포취집체(PNA)、혈소판-림파세포취집체(PlyA)、고민C반응단백(hs-CRP)치진행비교.재ACS조,근거환자입원시GRACE적분분치,장환자분성2조:저위조(0～108분)30례,고위조(≥109분)56례,비교저량조PLA적차별.이용Spearman상관성분석비교PLA、PMA、PNA、PlyA분별여hs-CRP급GRACE적분적상관성.결과 ACS조적PLA (4.40％±3.08％)、PMA (33.6％±21.5％)、PNA( 3.76％±5.06％)、PLyA(2.03％±1.27％)급hs-CRP[5.75(3.49,9.15)]균고우SAP조화대조조(P균＜0.05).GRACE적분고위조PMA치명현고우저위조(44.8％±18.0％비13.0％±6.3％,P＜0.01).Spearman상관성분석현시,hs-CRP여PMA정정상관(r =0.547,P＜0.001),여PLA、PNA、PlyA균무상관성.GRACE적분여PMA、PLA、PNA、PlyA균정정상관(r치분별위0.746、0.652、0.460、0.435,P균＜0.01).결론 PLA승고가능예시착ACS환자적불은정상태,ACS환자PLA수평명현승고,PLA여hs-CRP급GRACE적분정상관,제시PLA가작위예측ACS환자병정적지표지일.
Objective To compare the platelet-leukocyte-aggregates (PLAs)level among patients with acute coronary syndrome (ACS) and stable angina pectoris (SAP).Methods Hospitalized patients were divided into three groups [ ACS group ( n =86 ),SAP group ( n =54 ),the control group with 46patients without coronary artery disease ].PLAs were measured by flow cytometry at admission before coronary angiography.ACS patients were further divided into low-risk group (0 - 108 points) and high-risk group ( ＞ 109 points ) according to GRACE scores at admission.PLA,platelet-monocyte aggregations ( PMA),platelet-neutrophile aggregations ( PNA ),platelet-lymphocyte aggregations ( PlyA ) and hs-CRP values were compared among groups.Results PLA (4.40％ ± 3.08％ ),PMA (33.6％ ± 21.5％ ),PNA(3.76％ ±5.06％),PLyA (2.03％ ± 1.27％) and hs-CRP [5.75(3.49,9.15)] levels in ACS group were significantly higher than those in SAP and control groups ( all P ＜ 0.05 ).PLA was also significantly higher in high-risk group than in the low-risk group (44.8％ ± 18.0％ vs.13.0％ ± 6.3％,P ＜ 0.01 ).Spearman correlation analysis showed that hs-CRP was positively correlated with PMA ( r =0.547,P ＜0.01 ) and GRACE score is positively correlated with PMA,PLA,PNA and PlyA ( r =0.746,0.652,0.460,respectively,all P＜0.01).Conclusion PLAs is increased in ACS patients and higher PMA level is related with the unstable coronary syndrome in ACS patients.Increased PMA,PLA,PNA and PlyA levels is associated with higher GRACE score in ACS patients.