The Studies Of Vessel Cell Endothelial Function And Polymorphisms Of Angiotensin-Converting Enzyme Gene,Coagulation FactorsⅦ Gene And Apolipoprotein E Gene With Blood Stasis Syndrome In Coronary Heart Disease

Chapter 1:Association between vessel cell endothelial function and Blood Stasis Syndrome in Coronary Heart DiseaseBackground: The vessel endothelial dysfunction may be one of the most important mechanisms in the manifestation of CHD. Being vessel endothelial dysfunction, endothelium-dependent vasorelaxation function is decreased, platelets aggregate, leucocytes adhere to the walls of blood vessels and smooth muscle cells proliferate, even lead to the vessels hyperkinesia, thrombosis and the ruptures of unstable plaques. The vessel endothelial cell dysfunction can be measured with marker of serum. The heart blood stasis syndrome is one of the commonest syndrome, the vessel endothelial dysfunction is probably one of characteristics of HBSS in CHD.Objective: To investigate the mechanism of endothelium dysfunction and the mechanism of endothelium dysfunction in patients with the heart blood stasis syndrome in coronary heart disease.Methods: This was a case-control study, which enrolled 59 cases with HBSS, 50cases with non- HBSS and 46 cases without CHD. The levels ofantithrombin III(ATIII), GMP-140, tissue-type plasminogen activator(tPA), plasminogen activator inhibitor(PAI), angiotensin II(AgH), nitrogen monoxide(NO), endothelins(ET), soluble intercellular adhesion molecule- 1 (sICAM-1), and soluble vascular-cellular adhesion molecule-1 (sVCAM-1) were tested with radioimmunoassy and chemistry method.Results:l.The levels of Agll of HBSS group were significantly higher than those of none-HBSS group and healthy group (p<0.05 or 0.01). The levels of ET, NO, NO / ET of HBSS group were significantly lowerer than those of healthy group (p<0.05 or 0.01), but no significant difference compared with none-HBSS group.2. The level of ATIII of HBSS group was significantly lowerer than that of healthy group (p<0.05 or 0.01). The levels of GMP-140, PAI of HBSS group were significantly higher than those of none-HBSS group and healthy group (p<0.05 or 0.01). There was significant difference between HBSS group and healthy control group in activator of plasminogen(tPA), but no significant difference compared with none-HBSS group.3. The level of sICAM-1 of HBSS group was significantly higher than that of none-HBSS group and healthy group (p<0.05 or 0.01). The level of sVCAM-1 of HBSS group was significantly higher than that of healthy groupConclusions:1. There was impaired endothelium dependent vascular diastolic-systolic function in HBSS of CHD, being as impaired endothelium dependant vascular vasorelaxation function.2. There were the function disorders of coagulation, anti-coagulation andfibrinolysis in HBSS of CHD, the state of excessive coagulation, and deficiency fibrinolysis before thrombosis.3. There is abnormal expression of vascular-cellular adhesion molecule(CAM) and it may be chronic inflammation.