| Coronary atheroslerosis is a kind of disease that is involved with lipid , plaque rupture, platelet activation and aggregation, thrombosis, and et al. Endothelial dysfunction, plaque rupture activation and thrombosis are pathophysiologic foundation of acute coronary sydrome. von Willebrand factor ( vWF) is a index to reflect endothelial dysfunc-tion. Apha granule membrane protein ( GMP - 140 ) is a index to re-flect platelet activation. Our study through assaying plasma level of vWF and GMP - 140 of different patients with coronary atheroslerosis as to investigate clinic significance.Methods1. Patient selection ( 1 ) 74 hospitalized patients from Jan. to Oct. 2001 undergoing selective coronary angiography (GAG) were se-lected. (42 male, 32 female, mean age 56 ?11 years, range 30 to 80).Exclusion criteria . All patients were excluded when with one of these criteria. ( 1 ) Chronic hepatic, renal, hemostatic disorders, ma-lignancy or inflammatory conditions and other diseases that can induce thrombosis ( such as atrial fibrillation , rheumatic valvular heart dis-ease). (2) With a history of PTCA stent implantalion or CABG. (3) GAG demonstrated major epicardial coronary branch was completely occluded. (4) With a history of anti - platelet, antithrombotic or hae-mostatic drugs.2. CAG analysis and groups divid(1) 74 patients were divided into 3 groups based on plaque mor-phology. Group S ( n = 15 ) , concentric or eccentric stenosis with smooth borders; Group C ( n = 37 ) , eccentric stenosis with complex borders or accompanied with coronary thrombus or coronary artery spasm. Group N (n =22) ,CAG without coronary atheroslerosis.(2) At the same time , these patients were divided into group A ( n = 7) , group B ( n = 32) , group C ( n = 13) based on ACC/AHA classification for coronary angioplasty . The lesions in group A presen-ted A type. The lesions in group B presented B type. The lesions in group C presented C type.(3) Based on major epicardial coronary branches lesion that -≥ 50% stenosis. 37 patients with complex morphology were divided into group I ( n = 10, one - vessel CAD ) , group II ( n = 12, two - vessel CAD ; and group III ( n = 15 , three - vessel CAD ).(4) Based on stenosis scores method,50 -70% stenosis was re-corded 1 point; 71% -89% stenosis was recorded 2 points; ^90% stenosis was recorded 3 points. Then added up every point in every le-sion is LM,LAD,LCX and RCA. According the total points the 37 pa-tients were divided into group a (n =21, <5 points) and group b (n= 16, ≥ 5 points).(5 ) According AHA criterion left and right coronary artery were divided into 15 sections . Based on stenosis 2=50% lesion sections 37 patients were divided group x(n =21,≤3 sections)and group y (n =16, ≥4 sections) .3. Index assay. The plasma level of vWF and GMP - 140 was as-sayed using ELISA.4. Statistical analysis. All statistical analysis were performed with Windows SPSS 10. 0 . Continuous date are presented as mean ?SD if normally distributed . q and t test were used. Statistical signifi-cance was defined as P ≤0.05.Result( 1) Based on plaque morphology. The plasma level vWF in N, S,Cgroup wasl08. 39 ?14. 87,149. 10 ?10. 21,201. 10 ?0. 92(% ) respectively . The plasma level of GMP - 140 in N,S,C group was 11.91 ?.86,17.54 ?.09,29.38 ?. 17(ng/ml) respectively . Compared with group N, the plasma level of vWF and GMP - 140 in group C and group S was significantly higher ( P <0. 01) . The plasma level of vWF and GMP - 140 in group C was significantly higher than that in group S ( P<0.01).(2) Based on major epicardial coronary branches . The plasmalevel ofvWF in I,II,III group was 1 8 1 . 07 ?15. 06,198. 07 ?10. 76,216. 87 ?18. 09 (% ) respectively. The plasma level of GMP-140 in I,II,III group was 27. 55 ?. 43,28. 73 ?.62,31. 13 ?2. 61 (ng/ml) respectively. The plasma level of vWF,GMP - 140 in group III was significantly higher than that in group I and II( p < 0.01). The plasma level of vWF...
|
PDF Full Text Request