中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
7期
28-30
,共3页
冠状动脉狭窄%急性冠状动脉综合征%血管性血友病因子
冠狀動脈狹窄%急性冠狀動脈綜閤徵%血管性血友病因子
관상동맥협착%급성관상동맥종합정%혈관성혈우병인자
Coronary stenosis%Acute coronary syndrome%Von Willebrand factor
目的 探讨急性冠状动脉综合征(ACS)患者外周血血管性血友病因子(vWF)水平与冠状动脉病变程度的相关性.方法 选取行冠状动脉造影148例ACS患者为ACS组.按ACS患者冠状动脉造影结果,所示病变累及相关冠状动脉支数分为单支病变组(54例)、双支病变组(51例)及多支病变组(43例);并根据Gensini积分分为三组:Gensini积分≤20分31例(轻度组),Gensini积分21～40分47例(中度组),Gensini积分≥41分70例(重度组).选取稳定型心绞痛(SA)患者50例为SA组,并选取50例冠状动脉正常者为对照组.检测外周血vWF水平,同时检测血常规、凝血功能、肝肾功能、超敏C反应蛋白(hs-CRP)、血糖、血脂等,并分析外周血vWF水平与冠状动脉病变程度的相关性.结果 ACS组白细胞计数和hs-CRP水平显著高于SA组及对照组,差异有统计学意义(P＜0.05),但SA组与对照组比较差异无统计学意义(P＞0.05);三组血小板计数、凝血酶原时间、活化部分凝血酶原时间、空腹血糖、凝血酶时间、餐后2h血糖、三酰甘油、总胆固醇比较差异无统计学意义(P＞0.05).ACS组外周血vWF水平为(143.25±20.42)％,明显高于SA组和对照组的(102.77±11.84)％,(97.63±10.31)％,差异有统计学意义(P＜0.05).单支病变组外周血vWF水平为(127.34±9.35)％,双支病变组为(144.81±12.02)％,多支病变组为(159.55土18.62)％,单支病变组、双支病变组、多支病变组、对照组组间比较差异有统计学意义(P＜0.01);轻度组外周血vWF水平为(124.77土14.31)％,中度组为(132.53±16.38)％,重度组为(155.06±18.53)％,轻度组、中度组、重度组及对照组比较差异有统计学意义(P＜0.01).ACS患者外周血vWF水平与冠状动脉病变支数和冠状动脉造影Gensini积分呈正相关(r=0.698,0.683,P＜0.01).结论 ACS患者外周血vWF水平与冠状动脉病变严重程度关系密切,在评价ACS患者病情及指导治疗方面有重要临床意义.
目的 探討急性冠狀動脈綜閤徵(ACS)患者外週血血管性血友病因子(vWF)水平與冠狀動脈病變程度的相關性.方法 選取行冠狀動脈造影148例ACS患者為ACS組.按ACS患者冠狀動脈造影結果,所示病變纍及相關冠狀動脈支數分為單支病變組(54例)、雙支病變組(51例)及多支病變組(43例);併根據Gensini積分分為三組:Gensini積分≤20分31例(輕度組),Gensini積分21～40分47例(中度組),Gensini積分≥41分70例(重度組).選取穩定型心絞痛(SA)患者50例為SA組,併選取50例冠狀動脈正常者為對照組.檢測外週血vWF水平,同時檢測血常規、凝血功能、肝腎功能、超敏C反應蛋白(hs-CRP)、血糖、血脂等,併分析外週血vWF水平與冠狀動脈病變程度的相關性.結果 ACS組白細胞計數和hs-CRP水平顯著高于SA組及對照組,差異有統計學意義(P＜0.05),但SA組與對照組比較差異無統計學意義(P＞0.05);三組血小闆計數、凝血酶原時間、活化部分凝血酶原時間、空腹血糖、凝血酶時間、餐後2h血糖、三酰甘油、總膽固醇比較差異無統計學意義(P＞0.05).ACS組外週血vWF水平為(143.25±20.42)％,明顯高于SA組和對照組的(102.77±11.84)％,(97.63±10.31)％,差異有統計學意義(P＜0.05).單支病變組外週血vWF水平為(127.34±9.35)％,雙支病變組為(144.81±12.02)％,多支病變組為(159.55土18.62)％,單支病變組、雙支病變組、多支病變組、對照組組間比較差異有統計學意義(P＜0.01);輕度組外週血vWF水平為(124.77土14.31)％,中度組為(132.53±16.38)％,重度組為(155.06±18.53)％,輕度組、中度組、重度組及對照組比較差異有統計學意義(P＜0.01).ACS患者外週血vWF水平與冠狀動脈病變支數和冠狀動脈造影Gensini積分呈正相關(r=0.698,0.683,P＜0.01).結論 ACS患者外週血vWF水平與冠狀動脈病變嚴重程度關繫密切,在評價ACS患者病情及指導治療方麵有重要臨床意義.
목적 탐토급성관상동맥종합정(ACS)환자외주혈혈관성혈우병인자(vWF)수평여관상동맥병변정도적상관성.방법 선취행관상동맥조영148례ACS환자위ACS조.안ACS환자관상동맥조영결과,소시병변루급상관관상동맥지수분위단지병변조(54례)、쌍지병변조(51례)급다지병변조(43례);병근거Gensini적분분위삼조:Gensini적분≤20분31례(경도조),Gensini적분21～40분47례(중도조),Gensini적분≥41분70례(중도조).선취은정형심교통(SA)환자50례위SA조,병선취50례관상동맥정상자위대조조.검측외주혈vWF수평,동시검측혈상규、응혈공능、간신공능、초민C반응단백(hs-CRP)、혈당、혈지등,병분석외주혈vWF수평여관상동맥병변정도적상관성.결과 ACS조백세포계수화hs-CRP수평현저고우SA조급대조조,차이유통계학의의(P＜0.05),단SA조여대조조비교차이무통계학의의(P＞0.05);삼조혈소판계수、응혈매원시간、활화부분응혈매원시간、공복혈당、응혈매시간、찬후2h혈당、삼선감유、총담고순비교차이무통계학의의(P＞0.05).ACS조외주혈vWF수평위(143.25±20.42)％,명현고우SA조화대조조적(102.77±11.84)％,(97.63±10.31)％,차이유통계학의의(P＜0.05).단지병변조외주혈vWF수평위(127.34±9.35)％,쌍지병변조위(144.81±12.02)％,다지병변조위(159.55토18.62)％,단지병변조、쌍지병변조、다지병변조、대조조조간비교차이유통계학의의(P＜0.01);경도조외주혈vWF수평위(124.77토14.31)％,중도조위(132.53±16.38)％,중도조위(155.06±18.53)％,경도조、중도조、중도조급대조조비교차이유통계학의의(P＜0.01).ACS환자외주혈vWF수평여관상동맥병변지수화관상동맥조영Gensini적분정정상관(r=0.698,0.683,P＜0.01).결론 ACS환자외주혈vWF수평여관상동맥병변엄중정도관계밀절,재평개ACS환자병정급지도치료방면유중요림상의의.
Objective To investigate the correlation between plasma von Willebrand factor(vWF) and the extent of coronary artery lesion in acute coronary syndrome (ACS).Methods One hundred and forty eight ACS patients (ACS group) who performed coronary angiography (CAG) were divided into single stenosis group (54 patients),double stenosis group (51 patients) and multitude stenosis group (43 patients) by the number of stenosis through CAG.They were divided into mild group (Gensini score ≤ 20 points,31 patients),midrange group (Gensini score 21-40 points,47 patients) and severe group (Gensini score ≥ 41 points,70 patients).Fifty patients with stable angina pectoris (SA) were randomly selected and classified as SA group,while 50 patients with healthy coronary were randomly selected as control group.Blood sample of 248 patients were collected to detect the level of vWF,and blood routine examination,blood clotting function,liver and renal function,high sensitivity C-reactive protein (hs-CRP),blood glucose,blood fat were detected.The correlation between vWF and the extent of coronary artery lesion were analyzed.Results The level of white blood cell count (WBC) and hs-CRP in ACS group were significantly higher than those in SA group and control group (P ＜ 0.05).But the level of WBC and hs-CRP between SA group and control group had no significant difference (P ＞ 0.05).The level of blood platelet count,prothrombin time,partial prothrombin time,fasting blood glucose,thrombin time,2 h postprandial glucose,triglyceride,total cholesterol had no significant difference among three groups (P ＞ 0.05).The level of vWF in ACS group was significantly higher than that in SA group and control group [(143.25 ± 20.42)％ vs.(102.77 ± 11.84)％,(97.63 ± 10.31)％] (P ＜0.05).The level of vWF in single stenosis group,double stenosis group and multitude stenosis group was (127.34 ± 9.35)％,(144.81 ± 12.02)％,(159.55 ± 18.62)％,and significantly higher than that in control group (P ＜ 0.01).The level of vWF in mild group,midrange group and severe group was (124.77 ± 14.31)％,(132.53 ± 16.38)％,(155.06 ± 18.53)％,and significantly higher than that in control group (P ＜ 0.01).The level of vWF had significantly positive correlation with the number of stenosis and Gensini score (r =0.698,0.683,P ＜ 0.01).Conclusion The level of vWF in peripheral blood is closely related with the severity of ACS and has important clinical significance in evaluating the condition and guiding therapy in patients with ACS.
