血浆白三烯-B4浓度与冠状动脉斑块相关性的临床研究

目的通过测定不同类型冠心病患者血浆白三烯-B4(LT-B4)的水平,探讨其与冠心病(CHD)及冠状动脉病变的关系。方法入选400例患者,冠心病组310例,其中急性冠状动脉综合征(ACS)组217例,稳定性心绞痛(SAP)组93例,对照组90例。检测患者外周血浆LT-B4浓度。同时经选择性冠状动脉造影检查,明确冠状动脉病变情况。CHD组中85例患者接受64层螺旋CT冠状动脉成像检查,对冠状动脉内的主要斑块进行评价。结果冠心病组LT-B4水平明显高于对照组(t=12.365,P<0.05),ACS组LT-B4水平又明显高于SAP组(t=7.664,P<0.05)。随冠状动脉病变类型和冠状动脉病变程度的加重,LT-B4浓度逐渐升高;CHD患者的软斑块组、纤维斑块组较钙化斑块组血浆LT-B4浓度明显升高,差异有统计学意义;逐步回归分析表明LT-B4浓度与冠状动脉病变Gensini评分有显著相关性。结论 ACS患者白三烯-B4水平增高,并与冠脉病变的严重性明显正相关,血浆白三烯-B4检测结合64层螺旋CT测定能否提高判断ACS患者冠状动脉斑块性质的准确性,对ACS的诊断及对冠脉病变的判断有一定的预测作用。

Clinical study on relationship between the plasma LT-B4 levels and unstable plaque in acute coronary syndrome

Objective To explore the association between plasma Leukotriene B4(LT-B4) and the severity of coronary artery lesions in coronary heart disease (CHD) patients. Methods 400 patients were divided into the CHD group and the control group according to the Coronary Angiography (CAG) . 310 patients in the CHD group sub-divided into the ACS(n = 217) group and the stable angina pectoris (SAP) group(n = 93) according to clinical information. The severity and extent of coronary lesions was analyzed by CAG and typified by means of Gensini coronary score system. LT-B4 level in plasma of all patients were tested by Enzyme linked immunosorbent assay. Eighty-five patients with coronary heart disease underwent 64- slice spiral computed tomography coronary artery imaging. Results LT-B4 level in CHD patients increased significantly compared with the control group (P<0. 05) . The LT-B4 concentration in ACS group was much higher than that in SAP group ( P < 0. 05) . Conclusions The LT-B4 level in serum of patients with Coronary Heart Disease elevated significantly and might be implicated in pathological processe of the unstable atherosclerotic plaques.