The Correlations Between The Soluble P-selectin, High Sensitive C-Reactive Protein And Homocystein With Coronary Heart Diseases

Coronary heart disease(CHD)has been one of the major fatal diseases threatening people's lives in the world. Atherosclerosis(AS)is its pathologic basis.Its pathologic mechanisms include dysfunction of endothelium, smooth muscle cell proliferation, blood platelet activation and thrombosis formation. So the prevention and intervention of AS have become an important target of clinical study.Researchers have found that soluble P-selectin (sP-selectin) is a cellular adhesion molecule which plays an important role in mediating the interaction of activated endothelial cells or platelets with leukocytes during inflammatory response and thrombus formation. It is also a non invasive marker of coronary plaque destabilization which reflects the damage of endothelial cell and platelet activation.Recent evidence has demonstrated that atherosclerosis is not simply a disease of lipid deposition. Inflammation plays a major role in the initiation, progression, and destabilization of plaque. High-sensitivity C-reactive protein (hs-CRP) is a acute-phase reactant that reflects active systemic inflammation. Large circulating prospective trials have shown hs-CRP to be a strong predictor of future cardiovascular events. Increased hs-CRP concentration is in fact associated with higher cardiovascular events in individuals with atherosclerotic disease.Homocysteine (Hcy) is a new risk factor of coronary heart disease (CHD). Hcy can promote the occurrence and development of artherosclerosis (AS) in multiple mechanisms.Endothelial cells impairment and dysfunction are important beginning links of AS occurrence, endothelial cells secrete and release vasoactive substance to be out of balance,cause to coronarospasm and atherosclerotic plaque rupture, platelet aggregate and thrombogenesis, meanwhile endothelial cells antithrombotic capability degrade, the hematological coagulability increase, thrombogenesis is promoted, promote the occurrence and development of CHD.Objective:①To study whether the levels of the serum sP-selectin ,high sensitive C-reactive protein (hs-CRP) and Homocysteine (Hcy) can predict the severity of CHD and provide useful information to our diagnosis and treatment of CHD.②To study the correlation among the serum sP-selectin, Homocysteine (Hcy) and hs-CRP in patients with CHD.Methods:The levels of sP-selectin, hs-CRP, HCY were measured in 21 patients with acute myocardial infarction (group AMI), 25 patients with unstable angina pectoris (group UAP), 20patients with stable angina pectoris (group SAP), and 20 controls. The levels of sP-selectin ,HCY and hs-CRP were measured by ELISA technique.Results:①The levels of sP-selectin in group AMI (274.81±5.24) wg/L and group UAP (200.44±8.47)Ng/L were significantly higher than that in group SAP(103.87±9.59)wg/L and the controls(101.16±9.67)wg/L, the concentration of sP-selectin was similar in group SAP (103.87±9.59) wg/L and the controls (101.16±9.67) wg/L.②The levels of hs-CRP were markedly elevated in group AMI (4.10±1.69) mg/L compared to group UAP(2.22±0.49)mg/L and group SAP(0.76±0.51) mg/L, but there was no significant difference between group SAP(0.76±0.51)mg/L and the controls(0.74±0.35)mg/L.③The levels of Hcy were markedly elevated in group AMI (28.13±.6.17 ) mg/L compared to group UAP(19.58±3.07)mg/L and group SAP(11.09±2.16) mg/L, but there was no significant difference between group SAP(11.09±2.16)mg/L and the controls(10.44±1.99)mg/L.④There were obvious positive correlations, between the concentration of sP-selectin and hs-CRP (r=0.456, P<0.05),between the concentration of sP-selectin and HCY(r=0.848, P<0.05), between the hs-CRP and HCY(r=0.210, P<0.05).Conclusion:①ACS patients have higher level of P-selectin which indicates that platelet activation is more serious in ACS patients than in SAP patients.②ACS patients have higher level of hs-CRP which indicates that the vascular inflammation is more serious in ACS patients than in SAP patients.③ACS patients have higher level of HCY which indicates that the endothelial cells injury and activating inflammation response is more serious in ACS patients than in SAP patients.④sP-selectin is positively associated with Hs-CRP and Hcy. It is helpful to diagnosis,therapy and prognosis of CHD by detecting Hcy, sP-selectin and Hs-CRP associatedly.