不稳定型心绞痛患者外周血Ｍ－ＣＳＦ及ｓＩＣＡＭ－１水平变化.docVIP

不稳定型心绞痛患者外周血Ｍ－ＣＳＦ及ｓＩＣＡＭ－１水平变化 　　　【摘要】 目的 探讨不稳定型心绞痛患者外周血M-CSF和sICAM-1的变化及临床意义。方法 根据病史、症状、心肌酶、心电图及冠状动脉造影检查，选取研究对象143例，进行分组，不稳定型心绞痛患者(UA)96例，稳定型心绞痛患者(SAP)25例。选取健康体检者(N)22例为正常对照组。入院24 h内或接受体检当时采集血标本分装两个试管，分别离心、冻存待一次检测。均采用酶联免疫吸附实验方法测定外周血sICAM-1和M-CSF水平。比较三组对象外周血sICAM-1和M-CSF水平的差异；分析sICAM-1与M-CSF的相关性；对UA患者进行TIMI危险评分，按评分将患者分为高、中、低三组，比较各组间的sICAM-1和M-CSF水平。采用SPSS 13．0 统计软件对结果进行统计分析。结果 ①3组实验对象外周血sICAM-1和M-CSF水平的组间比较，不稳定型心绞痛组高于稳定型心绞痛组(Plt;0．001)，稳定型心绞痛组高于正常对照组(Plt;0．001)；②M-CSF与sICAM-1呈明显正相关；③不同TIMI危险积分组的组间比较，sICAM-1和M-CSF水平随TIMI危险积分的增高而增高，各组间比较差异均具有统计学意义。结论 sICAM-1和M-CSF共同参与冠脉斑块的形成，并相互促进对方的表达，二者均可作为不稳定型心绞痛患者危险评估的参考指标。 　　【关键词】不稳定型心绞痛；可溶性细胞间黏附分子-1；巨噬细胞集落刺激因子 　　 　　【Abstract】 Objective To explore the changes and the clinical value of M-CSF and sICAM-1 in peripheral blood of patients with unstable angina.Methods 121 patients were choosed according to patient history symptom screatase ECG and coronary arteriongraphy(CAG).22 health examination persons was choosed as normal control.Blood samples of patients were collected in 24 hours after admission.The peripheral blood levels of M-CSF and sICAM-1 were measured with enzyme-linked immunosorbent assay(ELISA).The risk scores of TIMI were calculated.the serumal levels of M-CSF and sICAM-1 were compared among the different risk scores groups.All result were analyzed with SPSS 13．0．Results ①The peripheral blood levels of M-CSF and sICAM-1 were higher in angina patients than in control group(all Plt;0．001); compared UA group with SA group,Plt;0．001; compared SAP group with control group,Plt;0．001．②The peripheral blood levels of M-CSF was positively correlated with sICAM-1．③The peripheral blood level of M-CSF was significantly positive correlated with the risk scores of TIMI.Conclusions The peripheral blood levels of M-CSF and sICAM-1 in patients with UA can reflect the patients，condition.Both of them have reference value in the dangerous classification of patients with UA. 　　【Key words】Unstable angina; Macrophage colony stimulating f