ST段抬高型心肌梗死患者内皮微粒及心肌损伤关系.docVIP

ST段抬高型心肌梗死患者内皮微粒及心肌损伤关系【摘要】目的 观察ST段抬高型心肌梗死患者外周血内皮微粒(CD31+/CD42b-)的水平，探讨CD31+/CD42b-内皮微粒与传统心肌损伤指标的相关性。方法 随机选取2010年1月至2010年12月经冠状动脉造影证实的冠心病患者44例，其中稳定性心绞痛(SAP)患者22例，ST段抬高型心肌梗死患者22例；同期门诊体检健康的对照组22例进行前瞻性观察研究。应用流式细胞仪检测入院时外周血CD31+/CD42b-内皮微粒的水平，应用生化分析仪检测肌酸激酶(CK)及其同工酶(CK-MB)，高敏C反应蛋白(hs-CRP)等；用化学发光仪检测肌钙蛋白I(cTnI)。STEMI组每4 h检测心肌损伤标志物直至入院后48 h。分析入院时血CD31+/CD42b-内皮微粒与心肌损伤标志物峰值的关系。结果 STEMI患者外周血CD31+/CD42b-内皮微粒的水平显著高于SAP组、正常对照组 (P＜0.01)，且SAP组与健康对照组比较差异无统计学意义(P＞0.05)。STEMI患者心肌损伤标志物(CK,CK-MB, cTnI 和hs-CRP)与循环血CD31+/CD42b- 的Spearman相关性分析结果分别为：r=0.489, P=0.021；r=0.501, P=0.018；r=0.491, P=0.02；r=0.612,P=0.002。结论 外周血CD31+/CD42b-内皮微粒的水平有可能成为预测STEMI患者心肌损伤的指标。 【关键词】心肌梗死；内皮微粒；心肌损伤 The relationship between endothelial microparticles in patients with ST- elevated myocardial infarction and myocardial injury QIN Guang-ming, JIN Ya-ping, YANG Xu-feng, JIANG Zhen-ni. Department of Clinical Laboratory Medicine, Second Affiliated Hospital Zhejiang University College of Medcine, Hangzhou 310009, China 【Abstract】Objective To observe the level of circulating CD31+/CD42b- endothelial microparticles in patients with ST- elevated myocardial infarction(STEMI), and discuss the correlation between CD31+/CD42b- and traditional myocardial injury index. Methods A total of 22 healthy subjects and 44 patients with angiographically confirmed coronary atherosclerotic lesions collected from January 2010 to December 2010 were studied prospectively. The patients were divided into SAP (stable angina pectoris, Canadian Cardiovascular Society, CCS Ⅱ to Ⅲ) group (n=22) and STEMI group (n=22). The level of circulating CD31+/CD42b-endothelial microparticles was detected by flow cytometric device after admission; creatine kinase (CK) and its isoenzymes (CK-MB) were detected by using biochemical analyzer; C-reactive protein was determined by a highly sensitive latex-enhanced turbidimetric immunoassay with a low detection limit of 0.25 mg/dl (IMMAGE, Beckman Coulter; Reagent from Orion Diagn Co. Ltd., Vantaa, Finland).