外周血中血管性血友病因子水平与ST段抬高型心肌梗死患者冠状动脉病变程度的关系
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摘要
目的研究外周血中血管性血友病因子(vWF)水平与ST段抬高型心肌梗死(STEMI)患者冠状动脉(冠脉)病变程度的关系。方法以2016年2月至2018年2月于我院收治的STEMI患者109例为研究对象,记为研究组。另取同期于接受体检的健康人员60例为对照组,分别比较两组患者的各项生化指标水平,并将研究组患者按照SYNTAX评分的不同分为轻度病变组、中度病变组及重度病变组,分别比较三组患者外周血vWF水平,并分析外周血vWF与STEMI患者冠脉病变程度的相关性。结果研究组白细胞计数(WBC)、C反应蛋白(CRP)及vWF水平均高于对照组,差异均有统计学意义(P均<0.05)。重度病变组外周血vWF水平高于轻度病变组与中度病变组,且中度病变组高于轻度病变组,差异均有统计学意义(P<0.05)。经Pearson相关性分析可得:外周血vWF、CRP、WBC水平与STEMI患者冠脉病变程度呈正相关关系(P<0.05)。结论 STEMI患者外周血vWF水平存在明显高表达,且与患者冠脉病变程度存在密切相关,可作为临床上早期诊断及评估STEMI患者的有效指标。
Objective To investigate the relationship between the level of von Willebrand factor(vWF) in peripheral blood and the severity of coronary artery disease in patients with ST-segment elevation myocardial infarction(STEMI). Methods A total of 109 STEMI patients admitted to our hospital from February 2016 to February 2018 were enrolled in the study group. Another 60 healthy people who received physical examination in our hospital during the same period were recorded as the control group, and the biochemical indicators of the two groups were compared. Patients in the study group were divided into mild lesion group, moderate lesion group and severe lesion group according to the SYNTAX score. The vWF levels in peripheral blood of three groups were compared, and the correlation between peripheral blood vWF and severity of coronary artery disease in STEMI patients was analyzed. Results The white blood cell count(WBC), C-reactive protein(CRP) and vWF levels in the study group were higher than those in the control group, and the differences were statistically significant(P<0.05).The level of vWF in the peripheral blood of the severe disease group was higher than that of the mild disease group and the moderate disease group, and the moderate disease group was higher than the mild disease group, the difference was statistically significant(P<0.05). According to Pearson correlation analysis, the levels of vWF, CRP and WBC in peripheral blood were positively correlated with the degree of coronary artery lesions in STEMI patients(P<0.05). Conclusion The level of vWF in peripheral blood of patients with STEMI is highly expressed, and it is closely related to the degree of coronary artery disease. It can be used as an effective indicator for early diagnosis and evaluation of STEMI patients.
Objective To investigate the relationship between the level of von Willebrand factor(vWF) in peripheral blood and the severity of coronary artery disease in patients with ST-segment elevation myocardial infarction(STEMI). Methods A total of 109 STEMI patients admitted to our hospital from February 2016 to February 2018 were enrolled in the study group. Another 60 healthy people who received physical examination in our hospital during the same period were recorded as the control group, and the biochemical indicators of the two groups were compared. Patients in the study group were divided into mild lesion group, moderate lesion group and severe lesion group according to the SYNTAX score. The vWF levels in peripheral blood of three groups were compared, and the correlation between peripheral blood vWF and severity of coronary artery disease in STEMI patients was analyzed. Results The white blood cell count(WBC), C-reactive protein(CRP) and vWF levels in the study group were higher than those in the control group, and the differences were statistically significant(P<0.05).The level of vWF in the peripheral blood of the severe disease group was higher than that of the mild disease group and the moderate disease group, and the moderate disease group was higher than the mild disease group, the difference was statistically significant(P<0.05). According to Pearson correlation analysis, the levels of vWF, CRP and WBC in peripheral blood were positively correlated with the degree of coronary artery lesions in STEMI patients(P<0.05). Conclusion The level of vWF in peripheral blood of patients with STEMI is highly expressed, and it is closely related to the degree of coronary artery disease. It can be used as an effective indicator for early diagnosis and evaluation of STEMI patients.
引文
[1]宋莉莉,王志胜,闫石芳,等.胰岛素样生长因子1与急性ST段抬高型心肌梗死患者冠状动脉无复流现象及冠状动脉病变程度的关系[J].中国医药,2016,11(7):979-83.
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[3]刘俊,杜丹心,刘佳,等.冠心病患者发病48h内同型半胱氨酸、血管性血友病因子和组织因子促凝活性的检测分析[J].国际检验医学杂志,2017,38(4):483-4.
[4]门剑龙,任静,张伯玮,等.血管性血友病因子预测非体外循环冠状动脉旁路移植术后缺血事件风险的研究[J].中华老年医学杂志,2014,33(11):1171-5.
[5]唐熠达.聚焦中国实践,遵循中国指南从2015中国STEMI指南更新谈抗栓治疗[J].浙江医学,2015,37(19):1563-4.
[6]张波,赵晓辉,晋军,等.SYNTAX积分在合并冠状动脉多支血管病变的STEMI患者急诊PCI策略中的应用[J].重庆医学,2016,45(21):2949-52.
[7]师静梅,廉秋芳,梁引红,等.脂联素与急性ST段抬高型心肌梗死患者冠状动脉病变程度的相关性研究[J].中国实用医刊,2017,44(23):10-2.
[8]丛辉,储海丹,景蓉蓉,等.冠状动脉粥样硬化性心脏病患者血浆的miR-125b-5p水平与病变程度相关性初探[J].中华检验医学杂志,2017,40(5):396-9.
[9]李秀琪,汪瀚,余稳,等.高敏肌钙蛋白T对急性非ST段抬高型心肌梗死的早期诊断价值[J].中国循证心血管医学杂志,2017,9(4):439-42.
[10]张海波,吴鹏,任平,等.血尿酸水平与高原中青年急性ST段抬高型心肌梗死患者冠状动脉病变程度及近期预后的关系研究[J].实用心脑肺血管病杂志,2017,25(10):24-7.
[11]杨军,王苏燕,张勇,等.冠心病患者血浆血管性血友病因子裂解酶、生长分化因子15水平变化及相关性分析[J].山东医药,2013,53(43):21-3.
[12]淡雪川,冯大超,王艳,等.氯吡格雷对老年急性冠脉综合征患者血小板P选择素、血管性血友病因子的影响[J].中国老年学杂志,2013,33(20):4981-3.
[13]周青,李剑,罗心平,等.血管性血友病因子和ADAMTS-13水平与急诊冠状动脉支架置入术后冠状动脉血流的关系[J].中华心血管病杂志,2011,39(3):212-6.
[14]白克庆.血清vWF、PRI对急性冠脉综合征患者氯吡格雷抵抗的临床价值[J].国际检验医学杂志,2018,39(6):746-8.
[15]杨阳,彭辉,陈建平,等.新疆维吾尔族急性冠脉综合征患者血清血管性血友病因子水平及相关因素分析[J].实用医学杂志,2014,33(3):406-9.
[16]金迪,海热尼沙·阿不都克日木,王玉伟,等.稳定性冠心病患者血浆血管性血友病因子水平及相关因素分析[J].新疆医学,2018,48(1):7-10.
[17]Spangenberg T,Budde U,Schewel D,et al.Treatment of acquired von Willebrand syndrome in aortic stenosis with transcatheter aortic valve replacement[J].JACC.Cardiovascular interventions,2015,8(5):692-00.
[18]Kumar M,Cao W,McDaniel JK,et al.Plasma ADAMTS13 activity and von Willebrand factor antigen and activity in patients with subarachnoid haemorrhage[J].Thrombosis and haemostasis,2017,117(4):691-9.
[2]王红娜,孔倩雯,房兆飞,等.aVR T波形态在评价老年ST段抬高型心肌梗死冠状动脉病变严重程度中的意义[J].心电与循环,2018,37(2):103-7.
[3]刘俊,杜丹心,刘佳,等.冠心病患者发病48h内同型半胱氨酸、血管性血友病因子和组织因子促凝活性的检测分析[J].国际检验医学杂志,2017,38(4):483-4.
[4]门剑龙,任静,张伯玮,等.血管性血友病因子预测非体外循环冠状动脉旁路移植术后缺血事件风险的研究[J].中华老年医学杂志,2014,33(11):1171-5.
[5]唐熠达.聚焦中国实践,遵循中国指南从2015中国STEMI指南更新谈抗栓治疗[J].浙江医学,2015,37(19):1563-4.
[6]张波,赵晓辉,晋军,等.SYNTAX积分在合并冠状动脉多支血管病变的STEMI患者急诊PCI策略中的应用[J].重庆医学,2016,45(21):2949-52.
[7]师静梅,廉秋芳,梁引红,等.脂联素与急性ST段抬高型心肌梗死患者冠状动脉病变程度的相关性研究[J].中国实用医刊,2017,44(23):10-2.
[8]丛辉,储海丹,景蓉蓉,等.冠状动脉粥样硬化性心脏病患者血浆的miR-125b-5p水平与病变程度相关性初探[J].中华检验医学杂志,2017,40(5):396-9.
[9]李秀琪,汪瀚,余稳,等.高敏肌钙蛋白T对急性非ST段抬高型心肌梗死的早期诊断价值[J].中国循证心血管医学杂志,2017,9(4):439-42.
[10]张海波,吴鹏,任平,等.血尿酸水平与高原中青年急性ST段抬高型心肌梗死患者冠状动脉病变程度及近期预后的关系研究[J].实用心脑肺血管病杂志,2017,25(10):24-7.
[11]杨军,王苏燕,张勇,等.冠心病患者血浆血管性血友病因子裂解酶、生长分化因子15水平变化及相关性分析[J].山东医药,2013,53(43):21-3.
[12]淡雪川,冯大超,王艳,等.氯吡格雷对老年急性冠脉综合征患者血小板P选择素、血管性血友病因子的影响[J].中国老年学杂志,2013,33(20):4981-3.
[13]周青,李剑,罗心平,等.血管性血友病因子和ADAMTS-13水平与急诊冠状动脉支架置入术后冠状动脉血流的关系[J].中华心血管病杂志,2011,39(3):212-6.
[14]白克庆.血清vWF、PRI对急性冠脉综合征患者氯吡格雷抵抗的临床价值[J].国际检验医学杂志,2018,39(6):746-8.
[15]杨阳,彭辉,陈建平,等.新疆维吾尔族急性冠脉综合征患者血清血管性血友病因子水平及相关因素分析[J].实用医学杂志,2014,33(3):406-9.
[16]金迪,海热尼沙·阿不都克日木,王玉伟,等.稳定性冠心病患者血浆血管性血友病因子水平及相关因素分析[J].新疆医学,2018,48(1):7-10.
[17]Spangenberg T,Budde U,Schewel D,et al.Treatment of acquired von Willebrand syndrome in aortic stenosis with transcatheter aortic valve replacement[J].JACC.Cardiovascular interventions,2015,8(5):692-00.
[18]Kumar M,Cao W,McDaniel JK,et al.Plasma ADAMTS13 activity and von Willebrand factor antigen and activity in patients with subarachnoid haemorrhage[J].Thrombosis and haemostasis,2017,117(4):691-9.