2018 年第 3 期 第 13 卷

血栓调节蛋白与冠状动脉慢血流的相关性研究

Correlation between thrombomodulin and coronary slow flow

作者：秦纲贾永平吕吉元

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单位：030001太原，山西医科大学第一医院心内科

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• 摘要：

• 目的    探讨血浆血栓调节蛋白水平与冠状动脉慢血流(CSF)的相关性。方法    选取2016年1—12月于山西医科大学第一医院因典型或不典型心绞痛行冠状动脉造影的患者94例，根据造影检查结果分为CSF组（52例）和冠状动脉血流正常组（对照组，42例）。入选患者入院后进行血细胞分析并检测相关生化指标；采用酶联免疫吸附试验法检测血浆血栓调节蛋白水平；以心肌梗死溶栓试验帧数（TFC）判定冠状动脉血流速度。采用Spearman检验分析血栓调节蛋白水平与平均TFC的相关性。结果    CSF组血浆血栓调节蛋白水平明显高于对照组［（4.0±0.3）μg/L比（3.6±0.3）μg/L］，差异有统计学意义（P＜0.05）。CSF组患者中左前降支CSF者42例(80.8%)，左回旋支CSF者11例(21.2%)，右冠状动脉CSF者29例(55.8%)。CSF组冠状动脉平均TFC明显高于对照组［（36±11）比（18±6）］，左前降支校正的TFC明显高于对照组［（43±12）比（22±7）］，左回旋支和右冠状动脉TFC明显高于对照组［（29±8）比（20±4）、（29±4）比（16±5）］，差异均有统计学意义（均P＜0.01）。Spearman相关分析显示，血栓调节蛋白水平、红细胞体积分布宽度与平均TFC呈正相关（r＝0.323，P＝0.002； r＝0.231，P＝0.016）。多元线性回归分析显示，血栓调节蛋白水平、红细胞体积分布宽度是CSF的独立危险因素（β＝0.201，P＝0.020； β＝0.087，P＝0.008)。结论    CSF患者血浆血栓调节蛋白水平升高；血栓调节蛋白水平可能是CSF的独立预测因子。

• Objective    To analyze the correlation between plasma thrombomodulin level and coronary slow flow（CSF）. Methods    Ninety-four patients with typical/atypical angina pectoris who had coronary angiography from January to December 2016 in First Hospital of Shanxi Medical University were enrolled. Fifty-two patients were diagnosed of CSF by coronary angiography（CSF group） and 42 patients showed normal coronary flow（control group）. Blood indicators, biological indexes and plasma level of thrombomodulin were tested; coronary flow rate was measured by the thrombolysis in myocardial infarction frame count. The correlation between thrombomodulin level and mean TFC was analyzed by Spearman test. Results    Plasma level of thrombomodulin in CSF group was significantly higher than that in control group［（4.0±0.3）μg/L vs（3.6±0.3）μg/L］(P＜0.05). There were 42 cases(80.8%) of left anterior descending artery slow flow, 11 cases(21.2%) of left circumflex artery slow flow and 29 cases(55.8%) of right coronary artery slow flow in CSF group. Mean TFC of coronary artery in CSF group was significantly higher than that in control group［（36±11） vs（18±6）］; corrected TFC of left anterior descending artery, TFC of left circumflex artery and right coronary artery in CSF group were significantly higher than those in control group［（43±12）vs（22±7）, （29±8）vs（20±4）, （29±4）vs（16±5）］(all P＜0.01). Spearman analysis showed that thrombomodulin level and red blood cell volume distribution width were positively correlated with mean TFC（r＝0.323, P＝0.002; r＝0.231, P＝0.016）. Multiple linear regression showed that both thrombomodulin level and red blood cell volume distribution width were independent risk factors of CSF（β＝0.201, P＝0.020; β＝0.087, P＝0.008). Conclusions    Patients with CSF had elevated levels of plasma thrombomodulin. Thrombomodulin may be an independent predictor of CSF.