急性冠状动脉综合征患者血管性血友病因子水平及与冠状动脉病变的关系

探讨急性冠状动脉综合征患者血管性假性血友病因子水平及其与冠状动脉粥样硬化病变的关系。应用酶联免疫吸附法检测 5 4例急性冠状动脉综合征患者、15例稳定型心绞痛患者和 2 0例冠状动脉造影正常者血浆血管性假性血友病因子水平 ,依据冠状动脉造影结果分为三支血管病变组 (n =31)、双支血管病变组 (n =18)和单支血管病变组 (n =2 0 ) ,比较各组血管性假性血友病因子水平的差异和分析血管性假性血友病因子与冠状动脉病变血管支数的关系。结果发现 ,急性冠状动脉综合征患者血浆血管性假性血友病因子水平明显高于稳定型心绞痛组 (P <0 .0 5 )和对照组 (P <0 .0 5 ) ;三支、双支血管病变组血管性假性血友病因子水平高于单支血管病变组 (P <0 .0 5 ) ;血管性假性血友病因子水平与冠状动脉病变血管支数呈正相关 (r=0 .2 2 4 ,P <0 .0 5 )。结果提示 ,急性冠状动脉综合征患者存在内皮功能的损害和高凝状态 ,血管性假性血友病因子是识别与预测不稳定性斑块的指标。血管性假性血友病因子水平受冠状动脉粥样病变程度的影响。

The Relationship between Von Willebrand Factor and the Coronary Stenosis in Acute Coronary Syndrome

Aim To investigate the association between von Willebrand factor (vWF) and the numbers of coronary artery stenotic lesions in acute coronary syndrome. Methods The concentration of plasma vWF was measured by enzyme linked immuoserbent assay (ELISA) in 54 patients with acute coronary syndrome and 15 stable angina pectoris and 20 normal persons without any angiographically detectable coronary artery disease. The relationship between plasma vWF level and the number of coronary vessels with stenosis was assessed. Results The concentrations of plasma vWF in patients with acute coronary syndrome were significantly higher than those in patients with stable angina pectoris (P<0.05) or control subjects (P<0.05). The level of plasma vWF was obviously higher in the multiple-vessel groups than in the single-vessel group (P<0.05), and the concentration of plasma vWF was positively related to number of vessels with percent stenosis of >50% diameter (r=0.224, P<0.05). Conclusions The vWF level, which is an indicator of thrombogenesis and endothelial damage, was significantly increased in patients with acute coronary syndrome. It is an indicator of distinguishing and predicting acute coronary instability and it is influenced by the degree of coronary atherosclerosis.