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目的评价血管内皮生长因子测定对急性冠脉综合征患者的临床意义。方法我院2006年1月至2008年12月入选急性冠脉综合征患者78例,双抗体夹心酶联免疫吸附法测定血管内皮生长因子浓度,并行冠状动脉造影了解冠脉狭窄情况。随访90d,记录主要心血管不良事件。结果冠脉无明显狭窄者、狭窄程度≤50%者、狭窄程度50%～80%者、狭窄程度>80%者四组间VEGF水平有差异(χ2=13.547,p=0.000)。两两比较表明狭窄程度≤50%组VEGF与无明显狭窄组比较差异无统计学意义;而狭窄程度50%～80%组和狭窄程度>80%组VEGF水平显著增高,与无明显狭窄组和狭窄程度≤50%组比较差异有统计学意义。78例患者随访90d内心原性猝死1例、非致死性心肌梗死5例、顽固性心绞痛11例、血运重建如支架植入12例。VEGF水平是产生主要心血管不良事件的独立危险因素,多因素分析调整后的OR值为1.017,95%CI为1.011-1.023。结论血管内皮生长因子浓度和急性冠脉综合征患者冠脉狭窄程度及主要心血管不良事件率相关,监测血管内皮生长因子浓度变化具有重要临床意义。
Objective To evaluate the clinical significance of vascular endothelial growth factor (VEGF) in patients with acute coronary syndrome. Methods From January 2006 to December 2008, 78 cases of acute coronary syndrome were enrolled in our hospital. The concentrations of vascular endothelial growth factor (VEGF) were measured by double antibody sandwich enzyme-linked immunosorbent assay (ELISA) and coronary angiography (CAG). After 90 days of follow-up, major adverse cardiovascular events were recorded. Results No significant coronary stenosis, stenosis ≤ 50%, stenosis of 50% to 80%, stenosis> 80% of the four groups were different VEGF levels (χ2 = 13.547, p = 0.000). The comparisons between two groups showed that there was no significant difference between the groups of stenosis less than or equal to 50% and the no stenosis group, while the level of VEGF between 50% and 80% stenosis group and 80% stenosis group was significantly higher than those without stenosis group and The stenosis less than or equal to 50% was statistically significant. One hundred and eight patients were followed up for 90 days. One case of sudden cardiac death, 5 cases of non-fatal myocardial infarction, 11 cases of refractory angina, and 12 cases of revascularization, such as stenting. The level of VEGF was an independent risk factor for major adverse cardiovascular events. The OR adjusted by multivariate analysis was 1.017 and the 95% CI was 1.011-1.023. Conclusion The concentration of vascular endothelial growth factor is related to the degree of coronary artery stenosis and the rate of major cardiovascular adverse events in patients with acute coronary syndrome. It is of great clinical significance to monitor the changes of vascular endothelial growth factor.