【摘要】 目的　探讨急性冠脉综合征 (ACS)患者外周血白细胞CD 11b/CD 18的表达率与冠脉病变特点两者的关系。方法　正常对照组 4 6例 ,稳定型心绞痛 (SAP)组 34例 ,不稳定型心绞痛 (UAP)组 4 5例 ,急性心肌梗死 (AMI)组 36例 ,分别于冠状动脉造影 (CAG)前抽取外周静脉血 ,以流式细胞仪测定中性粒细胞和单核巨噬细胞表面CD 11b/CD 18双阳性率表达程度 ;根据Braunwald心绞痛分级方法和定量CAG分析UAP患者的冠脉病变特点 ,分别将UAP组分成ⅠB、ⅡB、ⅢB级 ,并将病变长度、类型、累及血管数量和狭窄程度进行亚组分析。结果　AMI、UAP组CD11b/CD18双阳性率明显高于正常对照组和SAP组 (89.5 3± 13.4 5 ) %、(86 .4 9± 9.89) %与 (71.4 4± 14 .6 7) %、(6 9.75± 18.6 8) % (P <0 .0 1) ;ⅢB级UAP患者的CD11b/CD18双阳性率明显高于其他两组 (91.78± 5 .6 7) %与 (77.82± 9.6 5 ) % ,(76 .91± 8.15 ) % (P均 <0 .0 1) ;UAP组内长病变患者外周血粘附分子的阳性率虽高于非长病变患者 ,但无显著性差异 (P >0 .0 5 ) ;病变类型严重程度加重 ,其炎性指标也逐渐增加 ,但无显著性差异 (P >0 .0 5 ) ;而病变累及血管数量和病变狭窄程度在UAP亚组之间亦未见明显差异 (P >0 .0 5 )。结论　白细胞活化状态与冠脉病变情况相关更多还原

【Abstract】 Objective To investigate the relationship between expression of CD11b/CD18 of peripheral blood leukocytes and the coronary artery lesions in the patients with acute coronary syndrome(ACS)patients.Methods The double positive rates of CD11b/CD18 antigen on the surface of both peripheral blood polymorphonuclear leukocytes and monomacrophage in 36 cases with acute myocardial infarction(AMI), 45 cases with unstable angina pectoris(UAP), 34 cases with stable angina pectoris(SAP) and 46 normal control subjects were examined before coronary angiogram(CAG)by flow-cytometry. UAP patients were divided into three groups of IB, IIB, IIIB degree according to Braunwald methods and quantitative analysis of CAG, and subgroups were analyzed according to lesion length, lesion type, lesion degree, and the numbers of involved coronary arteries. Results Double CD11b/CD18 positive ratio in AMI and UAP groups was significantly higher than that in normal control group and SAP group( 89.5%±13.45% and 86.49%±9.89% vs 71.44%±14.67% and 69.75%±18.68%, P<0.01), which was also evidently higher in IIIB degree UAP patients than that of the other two groups(91.78%±5.67% vs 77.82%±9.65%, 76.91%±8.15%, P<0.01), while which was higher in long-term lesion of UAP group than that of non long-term lesion group,with no significant difference(P>0.05). There was no significant difference in CD11b/CD18 double positive ratio when inflammation markers were increased with the worsening of lesion severity, and no remarkable difference between the numbers of involved lesion vessels and the degree of lesion stenosis in the UAP subgroups(P>0.05). Conclusion There is correlation between coronary artery lesion and the activation of peripheral white blood cells.And the active index of white blood cells reflects the inflammation at plaque of coronary artery lesion.更多还原