终板-不稳定型心绞痛患者的血管内皮生长因子水平概念.docxVIP

不稳定型心绞痛患者的血管内皮生长因子水平 何文芳1 王喆1 蔡军1 池洪杰1 杨新春* 1首都医科大学附属北京朝阳医院心脏中心 北京 100020 2首都医科大学附属北京朝阳医院心脏中心 北京 100020 通讯作者：杨新春 【摘要】 目的 动物实验已证实冠状动脉缺血或堵塞会导致血管内皮生长因子（VEGF）表达增加，但在人类冠心病患者中的研究还不深入，我们拟评估不稳定型心绞痛患者的VEGF水平，并探讨其与冠脉病变程度、外周动脉张力及与其他危险因素的相关性。方法 连续入选2014年10-12月在我院住院的胸痛待查患者108例，根据造影结果分为两组，不稳定型心绞痛组78例（经冠脉造影证实至少一支冠状动脉直径≥50%）；冠脉造影正常的对照组30例。冠状动脉狭窄的严重程度应用冠脉Gensini评分，应用Endo-PAT2000测得的反应性充血指数(Reactive hyperemia index, RHI)评估患者外周动脉张力。评估不稳定型心绞痛患者的VEGF及RHI水平，相关性分析采用多重线性回归分析VEGF与RHI、内皮素-1（ET-1）、 高敏C反应蛋白（C-reactive protein, hs-CRP）、同型半胱氨酸（homocysteine, Hcy）、生化指标、危险因素、冠脉病变程度的相关性。结果 不稳定型心绞痛组VEGF水平显著高于对照组(102.11 ± 55.70 pg/ml vs.80.92 ± 38.10 pg/ml, p ＜0.05＝。不稳定型心绞痛组RHI显著低于对照组(1.53 ± 0.27 vs.1.65 ± 0.32, p＜0.05）。多重线性回归分析显示，VEGF与冠状动脉狭窄的程度、Gensini评分及RHI显著相关，有统计学意义(β= 36.74, p = 0.003;β = 0.47, p = 0.002;β = -78.60, p = 0.023)。结论 不稳定型心绞痛患者VEGF水平显著高于对照组。而RHI显著低于对照组。VEGF与冠状动脉狭窄的程度、Gensini评分及RHI显著相关。 关键词：不稳定型心绞痛 血管内皮生长因子 外周动脉张力 Concentration of vascular endothelial growth factor in patients with Unstable angina Xiangmin Lin, Xinchun Yang*, Zhe Wang, Jun Cai, Xiangmin Lin, Hongjie Chi Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China Abstract：Objective: It has been known that ischemia or occlusion of coronary arteries in animal models increases the production of vascular endothelial growth factor (VEGF); however, little is known about the relationship between coronary artery disease and VEGF in humans. In this study, our aim was to evaluate VEGF level and the relationships between the degree of coronary artery stenosis and plasma VEGF level as well as Gensini score, peripheral arterial tonometry and other risk factors in patients with established unstable angina（UAP）. Methods: A total of 108 consecutive patients treated at the Department of Cardiology of Beijing Chaoyang Hospital from October 2014 to December 2014 were enrolled retrospectively. According to the results of using coronary angiography (CAG), they were divided into a UAP group ( n