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目的探讨不稳定型心绞痛患者外周血M-CSF和sICAM-1的变化及临床意义。方法根据病史、症状、心肌酶、心电图及冠状动脉造影检查,选取研究对象143例,进行分组,不稳定型心绞痛患者(UA)96例,稳定型心绞痛患者(SAP)25例。选取健康体检者(N)22例为正常对照组。入院24 h内或接受体检当时采集血标本分装两个试管,分别离心、冻存待一次检测。均采用酶联免疫吸附实验方法测定外周血sICAM-1和M-CSF水平。比较三组对象外周血sICAM-1和M-CSF水平的差异;分析sICAM-1与M-CSF的相关性;对UA患者进行TIMI危险评分,按评分将患者分为高、中、低三组,比较各组间的sICAM-1和M-CSF水平。采用SPSS13.0统计软件对结果进行统计分析。结果①3组实验对象外周血sICAM-1和M-CSF水平的组间比较,不稳定型心绞痛组高于稳定型心绞痛组(P<0.001),稳定型心绞痛组高于正常对照组(P<0.001);②M-CSF与sICAM-1呈明显正相关;③不同TIMI危险积分组的组间比较,sICAM-1和M-CSF水平随TIMI危险积分的增高而增高,各组间比较差异均具有统计学意义。结论sICAM-1和M-CSF共同参与冠脉斑块的形成,并相互促进对方的表达,二者均可作为不稳定型心绞痛患者危险评估的参考指标。
Objective To investigate the changes and clinical significance of M-CSF and sICAM-1 in peripheral blood of patients with unstable angina pectoris. Methods According to the history, symptoms, myocardial enzymes, electrocardiogram and coronary angiography, 143 subjects were selected and divided into groups, 96 patients with unstable angina pectoris (UA) and 25 patients with stable angina pectoris (SAP). Twenty-two healthy subjects (N) were selected as normal control group. Within 24 h of admission or physical examination, blood samples were collected at the time of two test tubes, respectively, centrifuged, frozen to be tested once. Enzyme-linked immunosorbent assay was used to determine the levels of sICAM-1 and M-CSF in peripheral blood. The levels of sICAM-1 and M-CSF in peripheral blood were compared between the three groups. The correlation between sICAM-1 and M-CSF was analyzed. The risk of TIMI was assessed in UA patients. The patients were divided into high, The levels of sICAM-1 and M-CSF in each group were compared. SPSS13.0 statistical software for statistical analysis of the results. Results ① The levels of sICAM-1 and M-CSF in the peripheral blood of the 3 groups were higher than those in the stable angina group (P <0.001), those in the stable angina group were higher than those in the normal control group (P <0.001) ); ②M-CSF was positively correlated with sICAM-1; ③The levels of sICAM-1 and M-CSF increased with the increase of TIMI risk score in different groups of TIMI risk groups, with statistical differences among the groups Significance of learning. Conclusions Both sICAM-1 and M-CSF are involved in the formation of coronary plaque and promote the expression of each other, both of which can be used as a reference index for risk assessment of patients with unstable angina pectoris.