冠心病患者外周血血管性假血友病因子裂解酶水平的变化及临床意义
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湖南省科技厅重点资助项目(2009SK2010)


The Changes and Significance of ADAMTS-13 Levels in Patients with Coronary Heart Disease
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    目的 探讨不同危险分层的冠心病患者外周血血管性假血友病因子裂解酶(ADAMTS-13)水平的变化及与高敏C反应蛋白(hs-CRP)、氨基末端利钠肽前体(NT-proBNP)、超敏肌钙蛋白 (hs-cTn)水平和左心室射血分数(LVEF)的相关性。方法 选取冠心病患者96例,稳定型心绞痛(SAP)47例,急性冠状动脉综合征(ACS)49例,其中包括不稳定型心绞痛(UAP)26例和急性心肌梗死(AMI)23例;同时选取冠状动脉无狭窄的患者49例作为对照组,所有入选患者均在入院后即刻采血,而急性心肌梗死患者均为发病6 h内,并在入院10~14天后再次采血。用酶联免疫吸附试验(ELISA)测定血浆ADAMTS-13的浓度。结果 ACS组患者外周血ADAMTS-13水平(286.22±21.75 ng/L)明显低于SAP组(357.47±21.98 ng/L)和对照组(581.85±21.52 ng/L),AMI组与UAP组的外周血ADAMTS-13水平比较差异无统计学意义(256.21±29.43 ng/L比258.55±31.56 ng/L),AMI组10~14天后ADAMTS-13水平明显高于其急性期 (619.91±30.80 ng/L比256.21±29.43 ng/L)。ACS组hs-CRP、NT-proBNP、hs-cTn均明显高于对照组及SAP组,而LVEF低于对照组及SAP组,冠心病患者外周血ADAMTS-13水平的变化与其他血清学指标hs-CRP、NT-proBNP、hs-cTn等存在明显负相关,与LVEF存在明显正相关。结论 外周血ADAMTS-13水平变化与冠心病患者的危险分层密切相关,联合其他血清学指标和LVEF可能可以更好的预测冠心病患者急性心脏事件的发生。

    Abstract:

    Aim To investigate the peripheral blood of a disintegrin and metalloprotease with a thrombo spondin type 1 motifs 13(ADAMTS-13)levels in the patient with coronary heart disease (CHD) and its correlation with high-sensitive C-reactive protein (hs-CRP),N-terminal natriuretic peptide precursor (NT-proBNP),high-sensitive cardiac troponin(hs-cTn). Methods 145 cases of patients who underwent coronary angiography were selected as research subjects. They were divided into three groups by coronary angiography: 47 cases of patients with stable angina as SAP 49 cases of patients with acute coronary syndrome(ACS),including 26 cases of unstable angina(UAP) and 23 cases of acute myocardial infarction(AMI) 49 cases of patients with non-coronary heart disease as control group. The bloods of all patients were collected after inhospital,blood of the AMI group was collected again after 10~14 days as recovery period. The ADAMTS-13 levels of all patients were measured with ELISA. Results The ADAMTS-13 level in the ACS group (286.22±21.75 ng/L) was strikingly lower than that in the SAP group (357.47±21.98 ng/L) and the control group(581.85±21.52 ng/L),but there was no significant difference between the AMI group (256.21±29.43 ng/L) and UAP group(258.55±31.56 ng/L). The ADAMTS-13 level in the AMI group after 10~14 days was higher than that in the acute stage (619.91±30.80 ng/L vs 256.21±29.43 ng/L). In the ACS group,the hs-CRP,NT-proBNP,hs-cTn levels were higher than those in control group and the SAP group the LVEF was lower than that in control group and SAP group. The ADAMTS-13 levels had negative correlation with hs-CRP,NT-proBNP and hs-cTn,but had positive correlation with LVEF. Conclusion The ADAMTS-13 levels had close relation to the stability of coronary heart disease,and the combination with serological markers and LVEF could predict the occurrence of thrombotic events in patients with CHD better.

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杨 军,王苏燕,张 勇,王光辉,邝 孛,江振涛,文格波.冠心病患者外周血血管性假血友病因子裂解酶水平的变化及临床意义[J].中国动脉硬化杂志,2013,21(10):899~902.

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  • 收稿日期:2013-05-12
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