宋庆桥,胡元会,商秀洋,石洁,吴华芹,曹雪滨,李俊峡

• 1:中国中医科学院广安门医院
• 2:解放军第二五二医院
• 3:解放军白求恩国际和平医院

摘要(Abstract)：

目的探讨冠心病稳定型心绞痛患者血瘀证组织纤维蛋白溶解酶原激活物抑制剂-1(tPAI-1)、可溶性细胞间黏附分子-1(sICAM-1)和基质金属蛋白酶-9(MMP-9)表达变化及其相互关系。方法采用液相芯片分析系统同步检测206例经冠状动脉造影证实的稳定型心绞痛(SAP)患者血瘀证、非血瘀证及28例健康对照者血清tPAI-1、sICAM-1和MMP-9表达程度,并比较三者之间及其与冠脉病变程度的相关性。结果患者血瘀证、非血瘀证血清tPAI-1、sICAM-1和MMP-9表达均较对照组显著升高,血瘀证组高于非血瘀证组;血瘀证与tPAI-1、sICAM-1和MMP-9具有相关性,后三者之间具有相关性。结论 SAP患者具有一定程度炎性反应和高凝状态,血瘀证患者表现更为明显,可能为冠心病SAP患者中的高危人群。结合相关蛋白质指标可能提高危险分层的敏感性和特异性。

关键词(KeyWords)： 稳定型心绞痛;血瘀证;tPAI-1;MMP-9;sICAM-1

Abstract:

Keywords:

基金项目(Foundation): 国家“十一五”科技支撑项目(2006BAI21B04)

作者(Author): 宋庆桥,胡元会,商秀洋,石洁,吴华芹,曹雪滨,李俊峡

参考文献(References)：

• [1]李杰,袁肇凯.冠心病血瘀证的病机研究[J].中西医结合心脑血管病杂志,2006,4(7):613-615.
• [2]徐济民.缺血性心脏病诊断的命名及标准——国际心脏病学会和协会/世界卫生组织临床命名标准化专题组的联合报告[J].国外医学:心血管疾病分册,1979,19(6):365-366.
• [3]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.慢性稳定性心绞痛诊断与治疗指南[J].中华心血管病杂志,2007,35(3):195-206.
• [4]中国中西医结合学会活血化瘀专业委员会.血瘀证诊断标准[J].中西医结合杂志,1987,7(3):129.
• [5]Gensini G G.A more meaningful scoring system for determin-ing the severity of coronary heart disease[J].Am J Cardiol,1983,51(3):606.
• [6]曹国强,崔社怀,吴奎.哮喘患者血清可溶性E选择素、血管细胞黏附分子I浓度的变化[J].中国现代医学杂志,2004,14(22):52-54.
• [7]杨剑梅.细胞间黏附分子-1、血管细胞黏附分子-1与冠心病研究进展[J].新疆医学,2002,32(5):51-53.
• [8]Hwang S J,Ballantyne C M,Sharrett A R,et al.Circulatingadhesion molecules VCAM-1,ICAM-1,and E-selectin incarotid atherosclerosis and incident coronary heart diseasecases:the Atherosclerosis Risk In Communities(ARIC)study[J].Circulation,1997,96(12):4219-4225.
• [9]Balbay Y,Tikiz H,Baptiste R J,et al.Circulating interleukin-1 beta,interleukin-6,tumor necrosis factor-alpha,and solu-ble ICAM-1 in patients with chronic stable angina and my-ocardial infarction[J].Angiology,2001,52(2):109-114.
• [10]吴龙川,蔡鑫,邵杉,等.冠心病患者血清sCD40L和MMP-9水平变化及其相关性研究[J].西部医学,2009,21(7):1105-1107.
• [11]Robertson L,Grip L,Mattsson H L,et al.Release of protein as well as activity of MMP-9 from unstable atheroscleroticplaques during percutaneous coronary intervention.[J].J In-tern Med,2007,262(6):659-667.
• [12]Tayebjee M H,Lip G Y,Tan K T,et al.Plasma matrix metal-loproteinase-9,tissue inhibitor of metalloproteinase-2,andCD40 ligand levels in patients with stable coronary artery dis-ease[J].Am J Cardiol,2005,96(3):339-345.
• [13]Salomaa V,Stinson V,Kark J D,et al.Association of fibrirolyt-ic parameters with early atherosclerosis:the ARIC study[J].Circulation,1995,91(2):284.
• [14]Juhan-Vague J,Pyke S D,Alessi M C,et al.Fibrinolytic fac-tors and the risk of myocardial infarction or sudden death inpatients with angina pectoris.ECAT study Group.EuropeanConcerted Action on Thrombosis and Disabilities[J].Circulation,1996,94(9):2057-2063.
• [15]薛书峰,娄书花.心绞痛患者纤溶活性变化的研究[J].中国心血管病研究杂志,2005,3(6):8-10.
• [16]Akkus M N,Polat G,Yurtdas M,et al.Admission levels of C-reactive protein and plasminogen activator inhibitor-1 in pa-tients with acute myocardial infarction with and without car-diogenic shock or heart failure on admission[J].Int Heart J,2009,50(1):33-45.
• [17]Caputo M,Mantini G,Floriani l,et al.Tissue plasminogen acti-vator,tissue plasminogen activator inhibitor and lipoprotein(a)in patients with coronary,epinortic and peripheral occlusiveartery disease[J].Eur Heart J,1996,17(9):1329-1336.