冠状动脉疾病和急性心肌梗死患者血清可溶性黏附分子浓度升高。

Elevated serum concentrations of soluble adhesion molecules in coronary artery disease and acute myocardial infarction.

作者信息

Zeitler H, Ko Y, Zimmermann C, Nickenig G, Glänzer K, Walger P, Sachinidis A, Vetter H

机构信息

Medizinische Universitäts-Poliklinik, Willhelmstr. 35-37, Bonn D-53111, Germany.

出版信息

Eur J Med Res. 1997 Sep 29;2(9):389-94.

PMID:9300936

Abstract

OBJECTIVES

Adhesion molecules are involved in a number of chronic conditions and diseases like rheumatoid arthritis, tumor growth and wound repair. Soluble adhesion molecules (SAM) play an important role in angiogenesis which is a common aspect of the conditions mentioned above and atherosclerosis. The aim of the present study was to assess the prevalence and the impact of elevated soluble adhesive molecule plasma concentrations in patients with atherosclerosis.

DESIGN AND SUBJECTS

In this study, we measured the soluble forms of intercellular adhesive molecule (sICAM), endothelial adhesive molecule (sELAM) and vascular adhesive molecule (sVCAM) using a sandwich ELISA technique in plasma of patients with acute myocardial infarction (AMI), coronary heart disease (CHD) and in healthy subjects (HS).

RESULTS

Patients suffering from CHD and AMI showed significant higher plasma concentrations of sICAM (p <0. 05 and p <0.005), sELAM (p <0.01 and p <0.001) and sVCAM (p <0.001 and p <0.005) than HS. In patients with fatal outcome of myocardial infarction the plasma concentrations of sICAM, sELAM and sVCAM were significantly elevated compared to surviving patients (p <0.005; p <0.005; p <0.05). In patients undergoing thrombolytic therapy there were no significant differences of plasma adhesive molecule concentrations. The levels of SAM were not related to other risk factors like diabetes, nicotin abuse, hyperlipidemia, hypertension and a familiary history of cardiovascular disease.

CONCLUSIONS

Elevated levels of SAMs are found in patients with coronary heart disease. High SAM levels in plasma seem to be a prognostic factor in acute myocardial infarction. This effect is independent from other concomitant risk factors. Our results suggest that SAMs are involved both in acute phase of myocardial infarction and chronic process of atherosclerosis. It seems that similiar to other chronic inflammatory diseases, atherosclerosis seems to be modulated by soluble forms of adhesive molecules.

摘要

目的

黏附分子参与多种慢性疾病，如类风湿性关节炎、肿瘤生长和伤口修复。可溶性黏附分子（SAM）在血管生成中起重要作用，而血管生成是上述疾病及动脉粥样硬化的一个共同特征。本研究旨在评估动脉粥样硬化患者血浆中可溶性黏附分子浓度升高的患病率及其影响。

设计与研究对象

在本研究中，我们采用夹心酶联免疫吸附测定技术，检测急性心肌梗死（AMI）患者、冠心病（CHD）患者及健康受试者（HS）血浆中细胞间黏附分子（sICAM）、内皮黏附分子（sELAM）和血管黏附分子（sVCAM）的可溶性形式。

结果

冠心病和急性心肌梗死患者的sICAM（p<0.05和p<0.005）、sELAM（p<0.01和p<0.001）和sVCAM（p<0.001和p<0.005）血浆浓度显著高于健康受试者。心肌梗死致死患者的sICAM、sELAM和sVCAM血浆浓度显著高于存活患者（p<0.005；p<0.005；p<0.05）。接受溶栓治疗的患者血浆黏附分子浓度无显著差异。可溶性黏附分子水平与糖尿病、吸烟、高脂血症、高血压及心血管疾病家族史等其他危险因素无关。