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目的测定冠状动脉性心脏病患者外周血内皮微颗粒的水平,研究其与各种临床指标的相关性,探讨CD144+/Annexin V+内皮微颗粒与冠状动脉性心脏病患者发生急性缺血事件的关系。方法经冠状动脉造影确诊的冠状动脉性心脏病患者81例,根据临床症状、心电图及超敏肌钙蛋白结果将患者分为急性冠状动脉综合征组(A组,51例)和稳定型心绞痛组(B组,30例)。采用流式细胞术检测两组患者外周血中CD144+/Annexin V+的内皮微颗粒的水平,评估CD144+/Annexin V+内皮微颗粒与年龄、心率、血压、血脂、血糖、炎性指标、心肌标志物等各临床指标之间的相关性。结果与B组相比,A组的外周血CD144+/AnnexinV+内皮微颗粒的水平显著升高(P<0.01)。CD144+/Annexin V+内皮微颗粒的水平与脂蛋白a(r=0.886)、超敏C反应蛋白(r=0.404)、肌酸激酶同工酶(r=0.471)和超敏肌钙蛋白(r=0.240)均呈正相关(P值分别<0.01、0.05),与年龄、心率、收缩压、舒张压、脉压差、空腹血糖、餐后2h血糖、糖化血红蛋白、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇均不相关(P值均>0.05)。结论外周血CD144+/AnnexinV+内皮微颗粒的水平与脂蛋白a、超敏C反应蛋白、肌酸激酶同工酶、超敏肌钙蛋白有关,对于评价冠状动脉性心脏病高危状态具有较好的价值。
Objective To determine the level of endothelial micro-particles in peripheral blood of patients with coronary heart disease, and to explore the relationship between CD144 / Annexin V + endothelial micro-particles and acute ischemic events in patients with coronary heart disease. Methods Eighty-one patients with coronary heart disease diagnosed by coronary angiography were divided into acute coronary syndrome group (group A, n = 51) and stable angina pectoris group according to clinical symptoms, electrocardiogram (ECG) (Group B, 30 cases). Flow cytometry was used to detect the level of CD144 + / Annexin V + in the peripheral blood of the two groups and to evaluate the relationship between CD144 / Annexin V + endothelial micro-particles and age, heart rate, blood pressure, blood lipid, blood glucose, inflammatory markers, myocardial markers The correlation between the clinical indicators. Results Compared with group B, the level of CD144 + / AnnexinV + endothelial micro-particles in group A was significantly increased (P <0.01). The level of CD144 / Annexin V + endothelial micro-particles was positively correlated with the levels of lipoprotein a (r = 0.886), high sensitivity C reactive protein (r = 0.404), creatine kinase isoenzyme 0.240) (P <0.01, 0.05 respectively), which was positively correlated with age, heart rate, systolic blood pressure, diastolic blood pressure, pulse pressure difference, fasting blood glucose, postprandial 2h blood glucose, glycosylated hemoglobin, total cholesterol, triglyceride, Lipoprotein cholesterol, low density lipoprotein cholesterol were not related (P> 0.05). Conclusions The level of CD144 / AnnexinV + endothelial micro-particles in peripheral blood is associated with the levels of lipoprotein a, high-sensitivity C-reactive protein, creatine kinase and hypersept troponin, which are of great value in the evaluation of high risk of coronary heart disease .