Experimental And Clinical Study On Relation Between VWF,CEC And Unstable Plaque Of Atherosclerotic Vessels And Therapy Effect Of Benazepril

[Objectivel Currently, diagnosis of acute coronary syndromes(ACS) is mainly dependent on clinical manifestation and is deficient of index, which is sensitive and specific. It has been demonstrated that most of ACS onset is related to coronary plaque disruption. However, Evidence is presented that supports the view that endothelial dysfunction is an early marker of atherosclerosis and an important contributor to the atherogenic process. It has been reported that the plasma vWF is a good specific marker of endothelial cell dysfunction and CEC(circulating endothelial cells) is an only specific direct indicator of vascular injury in vivo. Therefore, the plasma vWF levels and CEC levels may reflect endothelium damage functionally and mechanically. In addition, benazepril(a kind drug of ACEI) can protect endothelium from damaging. We try to find relation between vWF,CEC and unstable plaque of atherosclerosis vessels and therapy effect of benazepril.with experimental and clinical study, so as to detect their diagnostic value to ACS and find a new way to treat coronary disease. IMethodsl (1) Animal experimental part: 34 New Zealand white rabbits were randomized into four groups of eight animals each for C,AS,P group and ten animals for?plaque rupture?group. In C group ,fed normal diet for ten weeks. In AS group, the 1% cholesterol diet was continued for ten weeks. Whereas, P group fed 1% cholesterol diet and receive benazepril 5mg /d each in drinking. In addition, ten rabbits of "plaque rupture" group were fed 1% cholesterol diet ten weeks with atherosclerosis induced by left carotid iliac damage. Ten weeks after the initiation of the diet, an angioplasty was performed. After angioplasty, the surviving rabbits(n=8) were randomized to receive benazepril(5mg/d,each) supplementation in drinking(P group,n=4) or no treatment(untreated group, n=4). The levels of CEC were measured by morphometrical counts at different periods(the 5^th week, the 10^th week). Endothelial cells were confirmed by the presence of Factor VIII-related antigen as the specific cell marker. At meantime, the levels of plasma vWF were determined by Enzyme Linked Immuno At the end of the experiment, the atherosclerosis of vessels were observed morphologically. (2) Clinical part: The levels of plasma vWF and CEC were measured in 29 patients with SA, 32 patients with UA, 27 patients with UA receiving benazelpril therapy, 28 patients with AMI and 23 health persons. The CEC was got by Percoll density gradient centrifugation, which was different from the methods in rabbits. [Resultsl (1) Animal experimental part: 1. Serum TC,TG,LDL-C were increased progressively in feeding rabbits with cholesterol diet and benazepril, but the results suggested that benazepril was able to inhibit the further progression of atherosclerosis.2.Atherogensis of rabbits was found at the tenth week with cholesterol diet. 3.The plasma vWF levels in AS group were increased progressively, whereas, in AS+P group there was no significant difference between the 5^th week and beginning, but the levels of plasma vWF at 10^th week were significantly higher than that at 5^th week. .The levels of plasma vWF in AS group were significantly higher than that in AS+P group at the 5^th and the 10^th week respectively. After angioplasty, the plasma vWF levels in untreated group were significantly higher than that in treat group. In treat group the levels of plasma vWF had no statistical difference between before and after angiopl...