CAJ | 학술논문

目的：观察研究急性冠状动脉综合征（ACS）患者血浆尾加压素Ⅱ（UⅡ）水平及动态变化与冠状动脉（冠脉）斑块稳定程度的相关性。 　　方法：连续入选2013-03至2013-08在我院心脏内科住院的ACS患者135例。健康对照者48例。测定ACS患者入院即刻血浆UⅡ、高敏C反应蛋白（hs-CRP）、N末端B型利钠肽原(NT-proBNP)水平。随访的58例ACS患者3个月门诊随访时测定UⅡ水平。 　　结果：ACS患者入院即刻血浆UⅡ水平较健康对照者显著升高[（39.82±22.28）pg/ml vs（26.88±6.09）pg/ml， P<0.001]；ST段抬高型心肌梗死（STEMI）患者入院即刻血浆UⅡ水平显著低于非ST段抬高型心肌梗死（NSTEMI）患者[（37.41±22.74）pg/ml vs（48.07±15.82）pg/ml，t=2.092，P<0.05]。ACS患者入院即刻血浆UⅡ水平与hs-CRP（r=0.041， P=0.639）、NT-proBNP（r=0.112，P=0.261）无相关关系。3个月时门诊随访的58例急性心肌梗死患者，血浆UⅡ水平为（56.52±20.70）pg/ml，较入院时（51.58±18.70） pg/ml显著增加，差异有统计学意义（t=-2.366，P<0.05）。 　　结论：不同临床类型的ACS患者入院即刻血浆UⅡ水平存在差别，从不稳定型心绞痛（UAP）到NSTEMI再到STEMI呈递减趋势，STEMI显著低于NSTEMI，随病情的稳定，ACS患者的血浆UⅡ水平呈显著升高趋势，入院即刻血浆UⅡ水平与炎性标记物hs-CRP和心室负荷标记物NT-proBNP不相关，冠心病患者血浆UⅡ水平不仅与动脉粥样硬化的程度，同时可能与动脉粥样硬化的性质或稳定性相关。
목적：관찰연구급성관상동맥종합정（ACS）환자혈장미가압소Ⅱ（UⅡ）수평급동태변화여관상동맥（관맥）반괴은정정도적상관성。 　　방법：련속입선2013-03지2013-08재아원심장내과주원적ACS환자135례。건강대조자48례。측정ACS환자입원즉각혈장UⅡ、고민C반응단백（hs-CRP）、N말단B형리납태원(NT-proBNP)수평。수방적58례ACS환자3개월문진수방시측정UⅡ수평。 　　결과：ACS환자입원즉각혈장UⅡ수평교건강대조자현저승고[（39.82±22.28）pg/ml vs（26.88±6.09）pg/ml， P<0.001]；ST단태고형심기경사（STEMI）환자입원즉각혈장UⅡ수평현저저우비ST단태고형심기경사（NSTEMI）환자[（37.41±22.74）pg/ml vs（48.07±15.82）pg/ml，t=2.092，P<0.05]。ACS환자입원즉각혈장UⅡ수평여hs-CRP（r=0.041， P=0.639）、NT-proBNP（r=0.112，P=0.261）무상관관계。3개월시문진수방적58례급성심기경사환자，혈장UⅡ수평위（56.52±20.70）pg/ml，교입원시（51.58±18.70） pg/ml현저증가，차이유통계학의의（t=-2.366，P<0.05）。 　　결론：불동림상류형적ACS환자입원즉각혈장UⅡ수평존재차별，종불은정형심교통（UAP）도NSTEMI재도STEMI정체감추세，STEMI현저저우NSTEMI，수병정적은정，ACS환자적혈장UⅡ수평정현저승고추세，입원즉각혈장UⅡ수평여염성표기물hs-CRP화심실부하표기물NT-proBNP불상관，관심병환자혈장UⅡ수평불부여동맥죽양경화적정도，동시가능여동맥죽양경화적성질혹은정성상관。
Objective: To observe the relationship between the dynamic changes of plasma levels of urotensin II (UII) and the stability of coronary atherosclerotic plaque in patients with acute coronary syndrome (ACS). Methods: Our research included 2 groups: ACS group,n=135 consecutive patients treated in our hospital from 2013-03 to 2013-08 that including unstable angina pectoris (UAP) sub-group,n=7, non-ST segment elevation myocardial infarction (NSTEMI) sub-group,n=22 and STEMI sub-group,n=106. In addition, there was a Control group,n=48 healthy subjects. Plasma levels of UII, hs-CRP and NT-proBNP were examined and compared among different groups at different time points. Results: Compared with Control group at immediate admission, ACS group had increased plasma level of UII (39.82 ± 22.28) pg/ml vs (26.88 ± 6.09) pg/ml,P<0.001; UII level in STEMI sub-group was lower than NSTEMI sub-group (37.41 ± 22.74) pg/ml vs (48.07 ± 15.82) pg/ml,t=2.092,P <0.05. In ACS patients, UII had no correlation to hs-CRP (r=0.041, P=0.639) and NT-proBNP (r=0.112,P=0.261) at immediate admission. There were 58 ACS patients finished the 3 months follow-up study and their UII level was increased than immediate admission as (56.52 ± 20.70) pg/ml vs (51.58 ± 18.70) pg/ml,t=-2.366,P<0.05. Conclusion: Plasma levels of UII have been changing in different type of ACS patients at immediate admission, UII presented decreasing trend from UAP to NSTEMI to STEMI, while it had increasing trend upon stabilized condition; the admission level of UII had no correlation to inflammatory marker hs-CRP and ventricular overload marker NT-proBNP. UII is not only related to the extent of atherosclerosis, but also related to the nature of atherosclerosis or the stability of plaques.