急性心肌梗死患者梗死冠状动脉中可溶性P选择素的浓度和白细胞计数与体循环不同。

Concentration of soluble P-selectin and white blood cell counts in infarct coronary arteries in patients with acute myocardial infarction differ from the systemic circulation.

作者信息

Yu Teng-Hung, Chua Sarah, Cheng Cheng-I, Liu Wen-Hao, Chiu Cheng-An, Yang Cheng-Hsu, Fang Chih-Yuan, Hsieh Yuan-Kai, Hang Chi-Ling, Hung Wei-Chin, Chen Yen-Hsun, Yeh Kuo-Ho, Fu Morgan, Yip Hon-Kan

机构信息

Division of Cardiology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.

出版信息

Chang Gung Med J. 2006 Mar-Apr;29(2):169-74.

PMID:16767965

Abstract

BACKGROUND

Previously, researchers have suggested that Soluble (s) P-selectin mediates the accumulation of leukocytes which in turn promotes fibril deposition. Soluble P-selectin and white blood cell (WBC) counts have been shown to be increased in the systemic circulation after acute myocardial infarction (AMI). However, whether the infarct coronary artery (ICA) and systemic circulation differs with respect to the concentration of sP-selectin and WBC counts following AMI remain unknown. In this study, we investigated whether the concentration of sP-selectin and WBC counts differed between the ICA and the systemic circulation after AMI.

METHODS

Blood samples for circulating sP-selectin and WBC counts were immediately obtained after vascular puncture in 72 patients with AMI of < 12 h undergoing primary percutaneous coronary intervention (PCI). Additionally, blood samples for ICA sP-selectin and WBC counts were obtained via Export Suction Catheter during PCI. For comparison, blood samples for sP-selectin and WBC counts were obtained once in 30 healthy subjects.

RESULTS

The results demonstrated that the circulating sP-selectin [64.7 +/- 18.1 (ng/ml) vs. 29.5 +/- 6.3 (ng/ml), p < 0.0001] and WBC counts [12.1 +/- 3.6 (x 10(3)/ml) vs. 5.0 +/- 1.0 (x 10(3)/ml), p < 0.0001] were significantly higher in our patients than in healthy subjects. Furthermore, the sP-selectin [72.7 +/- 23.3 (ng/ml) vs. 64.7 +/- 18.1 (ng/ml), p < 0.0001] and the WBC counts [16.2 +/- 3.8 (x 10(3/)ml) vs. 12.1 +/- 3.6 (x 10(3)/ml), p < 0.0001] were markedly higher in the ICA than in the systemic circulation for the patients.

CONCLUSIONS

The plasma level of sP-selectin and WBC counts were more elevated in the ICA than in the systemic circulation of patients with AMI undergoing primary PCI. These findings strengthen the role of sequestration of WBC and sP-selectin in the ICA as crucial in thrombus formation.

摘要

背景

此前，研究人员认为可溶性（s）P-选择素介导白细胞的聚集，进而促进纤维蛋白沉积。急性心肌梗死（AMI）后，全身循环中的可溶性P-选择素和白细胞（WBC）计数已被证明会升高。然而，AMI后梗死冠状动脉（ICA）和全身循环中sP-选择素浓度及WBC计数是否存在差异仍不清楚。在本研究中，我们调查了AMI后ICA和全身循环中sP-选择素浓度及WBC计数是否存在差异。

方法

对72例发病时间<12小时且正在接受直接经皮冠状动脉介入治疗（PCI）的AMI患者进行血管穿刺后，立即采集用于检测循环sP-选择素和WBC计数的血样。此外，在PCI期间通过导出抽吸导管采集用于检测ICA中sP-选择素和WBC计数的血样。作为对照，对30名健康受试者采集一次用于检测sP-选择素和WBC计数的血样。

结果

结果表明，我们的患者循环中的sP-选择素[64.7±18.1（ng/ml）对29.5±6.3（ng/ml），p<0.0001]和WBC计数[12.1±3.6（×10³/ml）对5.0±1.0（×10³/ml），p<0.0001]显著高于健康受试者。此外，患者ICA中的sP-选择素[72.7±23.3（ng/ml）对64.7±18.1（ng/ml），p<0.0001]和WBC计数[16.2±3.8（×10³/ml）对12.1±3.6（×10³/ml），p<0.0001]明显高于全身循环中的水平。