摘要
目的 观察血清磷脂酰胆碱 (PC)、磷脂酰丝氨酸 (PS)、磷脂酰乙醇氨 (PE)、磷脂酰肌醇 (PI)在不稳定型心绞痛(UAP)、急性心肌梗死 (AMI)、稳定型心绞痛 (SAP)患者中的变化 ,以早期发现、监测UAP和预测AMI的实验室指标。方法 将116例冠心病 (CHD)患者分为UAP组 60例、AMI组 41例、SAP组 15例 ,正常对照组 5 0例。抽取心绞痛发作或AMI发病 2 4h内空腹静脉血。利用高效液相色谱法测定血清中PC、PS、PE、PI的含量。并追踪随访心绞痛患者 6～ 18个月。结果 ①UAP组的PC明显高于SAP组和对照组 (均 P =0 0 0 0 1) ;AMI组的PC明显高于SAP组和对照组 (P =0 0 0 0 7,P =0 0 0 0 1)。②UAP组的PS明显高于AMI组、SAP组和对照组 (均P =0 0 0 0 1)。③UAP组的PE明显高于AMI组、SAP组和对照组 (P =0 0 0 2 5 ,P=0 0 0 15 ,P =0 0 0 0 1)。④UAP组的PC +PS明显高于AMI组、SAP组和对照组 (P =0 0 0 15 ,P =0 0 0 0 1,P =0 0 0 0 1) ;AMI组的PC +PS明显高于对照组 (P =0 0 0 0 1)。结论 UAP的诊断除临床表现、心电图改变等条件外 ,血清PC >1 0mg/mL ,同时伴有 (或只有 )PS >0 4mg/mL ,PE >0 0 8mg/mL ,可能作为辅助诊断的参考条件。在UAP治疗过程中 ,血清PC >1 15mg/mL ,PS >0 45mg/mL ,应视为UAP病情仍?
Objective This research focused on changes of the serum phospholipid including phosphatidylcholine(PC), phosphatidyl serine(PS),phosphatidylethanolamine(PE) and phosphatidylinositol(PI) in the patients suffering from unstable angina pectoris(UAP), acute myocardial infarction(AMI)and stable angina pectoris(SAP).The main purpose was to find out whether the value of serum paospholipid could be used as a criteria for diagnosis of UAP and prediction of AMI.Methods 116 cases of hospitalized CHD patients were divided into 3 groups:60 patients in the group of UAP;41 in the group of AMI;15 in the group of SAP;50 normal persons in the control group.Blood sample in fasting of UAP, AMI and SAP patients were collected within 24 hours after the heart attack.The concentration values of the serum phospholipids were measured by the method of high performance liquid chromatography.Angina pectoris(AP) patients followed up for 6～18 months.Results The results showed that ①The level of PC was significantly higher in UAP than that in SAP or control(P=0.0001,P=0.0001);the level of PC was significantly higher in AMI than that in SAP or control(P=0.0007,P=0.0001).②The level of PS was significantly higher in UAP than that in AMI,SAP or control(P=0.0001,P=0.0001,P=0.0001).③The level of PE was significantly higher in UAP than that in AMI,SAP or control(P=0.0025,P=0.0015,P=0.0001).④The level of PC plus PS was significantly higher in UAP than that in AMI,SAP or control(P=0.0015,P=0.0001,P=0.0001);the level of PC plus PS was significantly higher in AMI than that in control (P=0.0001).Conclusions Results indicated that levels of serum PC>1.0 mg/mL,when(or only) PS>0.4 mg/mL, PE>0.08 mg/mL might be another condition of UAP diagnosis,except for the symptoms of clinical and electrocardiogram.In the treatment of UAP,it was known as a progress of UAP state when serum PC>1.15 mg/mL, PS>0.45 mg/mL.The doctor should strengthen the treatment of UAP to prevent AMI.It prompted a bad prognosis when serum PC>1.2 mg/mL, PS>0.8 mg/mL, PE>0.09 mg/mL.
出处
《中国急救医学》
CAS
CSCD
北大核心
2003年第5期304-306,共3页
Chinese Journal of Critical Care Medicine
关键词
不稳定型心绞痛
急性心肌梗死
血清磷脂
高效液相色谱法
Unstable angina pectoris
Acute myocardial infarction
Serum phospholipid
High performance liquid chromatography
