摘要
目的观察不同类型冠心病患者外周血血浆中组织因子途径抑制物(TFP)I抗原水平变化,探讨TFPI在冠心病发生发展中的作用及其临床相关性.方法对66例CHD患者和22例非冠心病的正常对照者进行研究.AMI患者和UAP患者在入院后即刻应用低分子肝素抗凝治疗前抽取外周静脉血,SAP患者和正常对照组患者在入院后次日清晨空腹抽血,血标本离心处理提取血浆,超低温冻存备用.所有入选对象均行冠状动脉造影检查明确冠状动脉病变情况,检测血清总胆固醇、甘油三脂、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平.采用酶联免疫吸附法检测AMI组、UAP组、SAP组和正常对照组患者血浆中TFPI-1、TFPI-2抗原水平,应用SPSS13.0统计软件包对数据进行统计分析.结果(1)AMI组和UAP组患者血浆TFPI-1抗原水平分别为(32.05±8.52)ng/mL和(31.49±10.61)ng/mL,高于SAP组(19.93±9.22)ng/mL和正常对照组(19.21±9.60)ng/mL,差异有统计学意义(P<0.05),AMI组和UAP组、SAP组和正常对照组之间差异无统计学意义(P>0.05);(2)AMI组和UAP组患者血浆TFPI-2抗原水平分别为(4.56±0.96)ng/mL和(4.73±1.04)ng/mL,高于SAP组(2.43±1.07)ng/mL和正常对照组(2.06±0.64)ng/mL,差异有统计学意义(P<0.05),AMI组和UAP组、SAP组和正常对照组之间差异无统计学意义(P>0.05);(3)冠心病患者按Gensini积分分组,TFPI-1在三支病变组和双支病变组高于单支病变组,差异有统计学意义(P<0.05);TFPI-2水平在三组间差异无统计学意(P>0.05);(4)TFPI-1水平和TC、LDL-C水平正相关,相关系数分别为0.633和0.386(P<0.01);TFPI-2水平和TC、LDL-C水平呈弱正相关关系,相关系数分别为0.248和0.235(P<0.01);未发现TFPI-1、TFPI-2抗原水平与TG、HDL-C水平有相关性(P>0.05);(5)Spearman等级相关分析显示冠心病患者血浆TFPI-1和TFPI-2水平与冠脉支数无相关关系(P>0.05).结论急性冠脉综合征患者血液呈高凝状态,两者与冠状动脉事件密切相关,通过检测血浆TFPI-1、TFPI-2浓度并积极加强抗凝治疗可以预防冠脉事件的发生发展,两者与冠心病危险因素TC、LDL-C正相关.
Objective To investigate the changes of plasma levels of TFPI in different type of CHD patients and the association with coronary heart disease.Methods This study was conducted in 66 CHD patients and 22 healthy adults.The blood specimens were collected before using LMWH in AMI patients;and the blood specimens of SAP patients and healthy adults were collected on the second morning.After centrifugal treatment,the plasma was saved in a ultra-low temperature refrigerator.Coronary angiography was carried out on each one of the selected objects,and the levels of total TC,TG,HDL-Cand LDL-C were detected.The plasma TFPI-1 and TFPI-2 levels of patients in AMI group,UAP group,SAP group,and healthy control group were measured by enzyme-linked immunosorbent assay（ELISA）.The data were statistically analyzed by SPSS software.Results（1）The plasma TFPI-1 antigen levels were higher in the AMI and UAP groups than in the SAP and control groups[（32.05±8.52） and（31.49±10.61）]ng/mL vs[（19.93±9.22）and（19.21±9.60） ng/mL,P0.05）],there was no significant difference between the AMI group and UAP group,SAP group and control group.（2）The plasma TFPI-2 antigen levels were higher in the AMI and UAP groups than in the SAP and control groups[（4.56±0.96）and（4.73±1.04）ng/mLl vs（2.43±1.07）and（2.06±0.64）ng/mL,P0.05）],there was no significant difference between the AMI group and UAP group,SAP group and control group.（3）The plasma TFPI-1 levels were higher in those patients who had 3 sick coronaries and 2 coronaries than those who had 1 sick coronary（P0.05）,there was no difference of TFPI-2 among the there groups（P0.05）.（4）There was a positive relationship between the levels of plasma TFPI-1 and the levels of serum TC and LDL-C（r=0.633 and r=0.386,P0.01）,and between the levels of plasma TFPI-2 and the levels of serum TC and LDL-C（r=0.248 and r=0.235,P0.01）,there were no significant relationship between the levels of TFPI-1 and TFPI-2 and the levels of TG and HDL-C（P0.05）.（5）Spearman analysis showed there was no positive relationship between the plasma levels of TFPI-1 and TFPI-2 and the number of involved branches of coronary arteries（P0.05）.Conclusions The plasma TFPI antigen levels of ACS patients are higher than those of SAP patients and healthy adults,suggesting that the blood of ACS patients is in hypercoagulable states.The plasma TFPI antigen levels are closely related with coronary artery events.Detecting the plasma TFPI-1 and TFPI-2 levels and active anticoagulant therapy can effectively prevent the incidence of coronary artery events.There is a positive relationship between plasma TFPI levels and serum TC and LDL-C levels.
出处
《昆明医学院学报》
2011年第11期68-73,共6页
Journal of Kunming Medical College
基金
昆明医学院研究生创新基金资助项目(KM2007L30)
关键词
冠心病
组织因子
组织因子途径抑制物
Coronary heart disease
Tissue factor
Tissue factor pathway inhibitor
