血浆hs—CRP、vWF及其裂解酶含量与急性冠脉综合征

目的：检测不稳定型心绞痛（UAP）、急性心肌梗死（AMI）等急性冠脉综合征（ACS）患者血浆中高敏C反应蛋白（h—CRP）和血管性血友病因子（vWF）及其裂解酶（vWF-cp）水平，探讨它们在ACS发病机制中的作用和相互联系。方法：研究对象分UAP组和AMI组（入院即刻采血），稳定型心绞痛（SAP）组和正常对照组（于入院次日空腹采血），各组均17例；应用酶联免疫吸附试验（ELISA）测定血浆vWF浓度和hs-CRP含量，以残余胶原结合力试验测定血浆vWF-cp活性水平。所有入选对象均行冠状动脉造影证实。结果：①UAP组和AMI组血浆hs-CRP与vWF水平均高于SAP组和正常对照组（P〈0．01）；②UAP组和AMI组血浆vWF—cp活性水平均低于SAP组和正常对照组（P〈0．01）；③ACS患者血浆hs—CRP与vWF水平间呈显著正相关（r=0．67，P〈0．01），而血浆vWF-cp与vWF、hs—CRP无明显相关关系。结论：①血浆hs—CRP、vWF水平升高可能是预测ACS斑块破裂和血栓形成的指标；②血浆vWF—cp活性降低在ACS血栓形成中可能起重要作用。

Correlation among plasma high sensitivity C-reactive protein and von Willebrand factor, vWF-cleaving protease levels in acute coronary syndrome

Objective： To evaluate the role of plasma high sensitivity C-reactive protein （hs-CRP）, yon Willebrand factor （vWF）, yon Willebrand factor-cleaving protease （vWF-cp） in the pathogenesis of acute coronary syndrome （ACS）. Methods： In 34 ACS patients, 17 unstable angina pectorix （UAP） patients composed UAP group and 17 acute myocardial infarction （AMI） patients composed AMI group： Another 17 stable angina pectoris （SAP） patients composed SAP group, 17 healthy persons regard as control group. Plasma contents of vWF and hs-CRP were measured using enzyme llke immunosorbent assay （ELISA）. The plasma vWF-ep activity was measured by residual collagen binding activity （R-CBA）. Coronary angiography was performed in all patients and normal control persons. Results： （1）Plasma levels of hs-CRP, vWF were significantly higher in patients with ACS than those with SAP and normal controls （P〈0.01）; （2）The plasma vWF-cp activity was significantly lower in patients with ACS than those with SAP and normal controls （P〈0.01） ; （3） In ACS patients the level of vWF in plasma was positively correlated with hs-CRP （respectively r=0.67, P〈0.01 ）, but vWF and hs-CRP were no obvious relationship with vWF- cp （P〉0.05）. Conclusion： （1）The increased plasma hs-CRP and vWF levels may be predictors of the plaque rupture and thrombosis in ACS patients; （2）The decreased plasma vWF-cp activity would play an important role in the throm- bosis of ACS.