中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2014年
9期
740-743
,共4页
杨丽霞%田祥全%郭瑞威%刘宏%齐峰%叶金善
楊麗霞%田祥全%郭瑞威%劉宏%齊峰%葉金善
양려하%전상전%곽서위%류굉%제봉%협금선
冠状动脉硬化%细胞外基质%尿纤溶酶原激活物%基质金属蛋白酶诱导因子
冠狀動脈硬化%細胞外基質%尿纖溶酶原激活物%基質金屬蛋白酶誘導因子
관상동맥경화%세포외기질%뇨섬용매원격활물%기질금속단백매유도인자
Coronary arteriosclerosis%Extracellular matrix%Urinary plasminogen activator%Matrix metalloproteinase inducer
目的 探讨冠心病患者外周血细胞外基质金属蛋白酶诱导因子(EMMPRIN)、尿激酶型纤溶酶原激活物(uPA)水平与斑块形态特征的关系.方法 入选136例患者,分为急性冠状动脉综合征(ACS)组88例,稳定性心绞痛(SAP)组48例,采用流式细胞技术检测外周血单核细胞上EMMPRIN表达情况,以平均荧光强度(MFI)反映其表达强弱.ELISA技术检测外周血uPA水平.根据冠状动脉造影斑块形态特征分为Ⅰ型斑块(33例)、Ⅱ型斑块(59例)和Ⅲ型斑块(44例),其中108例接受64层螺旋CT冠状动脉成像检查,根据冠状动脉粥样斑块CT值分为软斑块(42例)、纤维斑块(34例)和钙化斑块(32例),比较不同斑块类型间EMMPRIN及uPA水平变化.结果 (1) ACS组主要为Ⅱ型斑块(48例)、软斑块(35例);SAP组主要为Ⅰ型(20例)、Ⅲ型(17例)、纤维斑块(16例)和钙化斑块(22例).(2)Ⅱ型斑块者EMMPRIN水平(MFI:11.61 ±0.81)和uPA[(0.89 ±0.17)mg/L]高于Ⅰ型斑块者[EMMPRIN MFI:6.65±1.32,uPA:(0.53±0.06) mg/L]及Ⅲ型斑块者[EMMPRIN MFI:9.47±1.16,uPA:(0.56 ±0.04) mg/L](P均＜0.05),Ⅲ型斑块者EMMPRIN水平高于Ⅰ型斑块者(P＜0.05),但两组间uPA水平差异无统计学意义.(3)软斑块者(EMMPRIN MFI:11.37 ±0.76)、uPA[(0.97 ±0.12)mg/L]高于纤维斑块[EMMPRIN MFI:8.93±1.21,uPA:(0.52±0.09) mg/L]及钙化斑块[EMMPRIN MFI:6.94±1.19,uPA:(0.49±0.12) mg/L](P均＜0.05),纤维斑块EMMPRIN水平高于钙化斑块(P＜0.05),但2组间uPA水平差异无统计学意义.结论 冠心病患者随着EMMPRIN、uPA表达水平升高,冠状动脉粥样斑块的稳定性下降,提示EMMPRIN与uPA可能共同参与了ACS斑块不稳定过程,对于ACS的早期诊断可能有一定预测价值.
目的 探討冠心病患者外週血細胞外基質金屬蛋白酶誘導因子(EMMPRIN)、尿激酶型纖溶酶原激活物(uPA)水平與斑塊形態特徵的關繫.方法 入選136例患者,分為急性冠狀動脈綜閤徵(ACS)組88例,穩定性心絞痛(SAP)組48例,採用流式細胞技術檢測外週血單覈細胞上EMMPRIN錶達情況,以平均熒光彊度(MFI)反映其錶達彊弱.ELISA技術檢測外週血uPA水平.根據冠狀動脈造影斑塊形態特徵分為Ⅰ型斑塊(33例)、Ⅱ型斑塊(59例)和Ⅲ型斑塊(44例),其中108例接受64層螺鏇CT冠狀動脈成像檢查,根據冠狀動脈粥樣斑塊CT值分為軟斑塊(42例)、纖維斑塊(34例)和鈣化斑塊(32例),比較不同斑塊類型間EMMPRIN及uPA水平變化.結果 (1) ACS組主要為Ⅱ型斑塊(48例)、軟斑塊(35例);SAP組主要為Ⅰ型(20例)、Ⅲ型(17例)、纖維斑塊(16例)和鈣化斑塊(22例).(2)Ⅱ型斑塊者EMMPRIN水平(MFI:11.61 ±0.81)和uPA[(0.89 ±0.17)mg/L]高于Ⅰ型斑塊者[EMMPRIN MFI:6.65±1.32,uPA:(0.53±0.06) mg/L]及Ⅲ型斑塊者[EMMPRIN MFI:9.47±1.16,uPA:(0.56 ±0.04) mg/L](P均＜0.05),Ⅲ型斑塊者EMMPRIN水平高于Ⅰ型斑塊者(P＜0.05),但兩組間uPA水平差異無統計學意義.(3)軟斑塊者(EMMPRIN MFI:11.37 ±0.76)、uPA[(0.97 ±0.12)mg/L]高于纖維斑塊[EMMPRIN MFI:8.93±1.21,uPA:(0.52±0.09) mg/L]及鈣化斑塊[EMMPRIN MFI:6.94±1.19,uPA:(0.49±0.12) mg/L](P均＜0.05),纖維斑塊EMMPRIN水平高于鈣化斑塊(P＜0.05),但2組間uPA水平差異無統計學意義.結論 冠心病患者隨著EMMPRIN、uPA錶達水平升高,冠狀動脈粥樣斑塊的穩定性下降,提示EMMPRIN與uPA可能共同參與瞭ACS斑塊不穩定過程,對于ACS的早期診斷可能有一定預測價值.
목적 탐토관심병환자외주혈세포외기질금속단백매유도인자(EMMPRIN)、뇨격매형섬용매원격활물(uPA)수평여반괴형태특정적관계.방법 입선136례환자,분위급성관상동맥종합정(ACS)조88례,은정성심교통(SAP)조48례,채용류식세포기술검측외주혈단핵세포상EMMPRIN표체정황,이평균형광강도(MFI)반영기표체강약.ELISA기술검측외주혈uPA수평.근거관상동맥조영반괴형태특정분위Ⅰ형반괴(33례)、Ⅱ형반괴(59례)화Ⅲ형반괴(44례),기중108례접수64층라선CT관상동맥성상검사,근거관상동맥죽양반괴CT치분위연반괴(42례)、섬유반괴(34례)화개화반괴(32례),비교불동반괴류형간EMMPRIN급uPA수평변화.결과 (1) ACS조주요위Ⅱ형반괴(48례)、연반괴(35례);SAP조주요위Ⅰ형(20례)、Ⅲ형(17례)、섬유반괴(16례)화개화반괴(22례).(2)Ⅱ형반괴자EMMPRIN수평(MFI:11.61 ±0.81)화uPA[(0.89 ±0.17)mg/L]고우Ⅰ형반괴자[EMMPRIN MFI:6.65±1.32,uPA:(0.53±0.06) mg/L]급Ⅲ형반괴자[EMMPRIN MFI:9.47±1.16,uPA:(0.56 ±0.04) mg/L](P균＜0.05),Ⅲ형반괴자EMMPRIN수평고우Ⅰ형반괴자(P＜0.05),단량조간uPA수평차이무통계학의의.(3)연반괴자(EMMPRIN MFI:11.37 ±0.76)、uPA[(0.97 ±0.12)mg/L]고우섬유반괴[EMMPRIN MFI:8.93±1.21,uPA:(0.52±0.09) mg/L]급개화반괴[EMMPRIN MFI:6.94±1.19,uPA:(0.49±0.12) mg/L](P균＜0.05),섬유반괴EMMPRIN수평고우개화반괴(P＜0.05),단2조간uPA수평차이무통계학의의.결론 관심병환자수착EMMPRIN、uPA표체수평승고,관상동맥죽양반괴적은정성하강,제시EMMPRIN여uPA가능공동삼여료ACS반괴불은정과정,대우ACS적조기진단가능유일정예측개치.
Objective To explore the association between extracellular matrix metalloproteinase inducer(EMMPRIN) and urokinase-type plasminogen activator (uPA) and the severity of coronary artery lesions in coronary heart disease (CHD) patients.Methods This study enrolled 88 patients with acute coronary syndrome (ACS) and 46 patients with stable angina pectoris (SAP).The mean fluorescence intensity (MFI) of EMMPRIN on monocytes of peripheral blood (PBMCs) were examined by flow cytometry.uPA in serum was measured with ELISA.64-slice spiral computed tomography coronary artery imaging was performed in 108 CHD patients.Coronary artery plaques were divided into type Ⅰ (33 patients),type Ⅱ (59 patients) and type Ⅲ (44 patients) through plaque morphology characteristics according to coronary angiography.Coronary artery plaques were divided into soft (42 patients),fibrous (34 patients) and calcified plaque (32 patients) according to CT characteristics.Results (1)Type Ⅱ plaque(48 patients)and soft plaque (35 patients) were the major plaque types in the ACS patients,while type Ⅰ plaque (20 patients) and type Ⅲ plaque (17 patients) and fibrous plaque (16 patients) and calcified plaque (22 patients)were the major plaque types in the SAP patients.(2)The EMMPRIN expression and uPA levels were significantly higher in type Ⅱ plaque group (EMMPRIN MFI:1 1.61 ± 0.81,uPA:(0.89 ± 0.17) mg/L) than those in the type Ⅰ plaque group (EMMPRIN MFI:6.65 ± 1.32,uPA:(0.53 ±0.06) mg/L) and in the type Ⅲ plaque group (EMMPRIN MFI:9.47 ± 1.16,uPA:(0.56 ±0.04) mg/L,all P ＜ 0.05).The EMMPRIN expression was higher in the type Ⅲ plaque group (MFI:9.47± 1.16)than in the type Ⅰ plaque group (MFI:6.65 ± 1.32,P ＜ 0.05),but uPA levels were similar between the 2 groups ((0.56 ± 0.04) mg/L vs.(0.53 ± 0.06) mg/L).(3) The EMMPRIN expression and uPA levels in the soft plaque group (EMMPRIN MFI:11.37 ± 0.76,uPA:(0.97 ± 0.12) mg/L) were significantly higher than those in the fibrous plaque group (EMMPRIN MFI:8.93 ± 1.21),uPA:(0.52 ±0.09) mg/L) and calcified plaque group (EMMPRIN MFI:6.94 ± 1.19,uPA:(0.49 ± 0.12) mg/L,P ＜0.05).The EMMPRIN expression in the fibrous plaque group(MFI:8.93 ± 1.21) was higher than in the calcified plaque group (MFI:6.94 ± 1.19,P ＜ 0.05),but uPA levels were similar between the two groups.Conclusion Higher EMMPRIN expression and uPA levels were associated with plaque instability,which might be used to evaluate plaque stability in CHD patients.
