| BackgroundCoronary heart disease (CHD) has become a serious hazard to human health, and affected people's quality of life. In China ,there was an upward trend year by year. Acute coronary syndrome (ACS) is a group of emergency cases of coronary heart disease,including unstable angina pectoris (UAP), acute myocardial infarction (AMI) and sudden cardiac death. Studies show that rupture of vulnerable coronary atherosclerotic and secondary thrombosis is the main pathogenesis of ACS. However, the initiating mechanism of leading to plaque rupture and thrombosis of is not entirely clear. Whether unique markers of these pathophysiological process exist, whether they can predict the occurrence of these acute events? Whether they are meaningful to the severity of coronary stenosis? So far there is no clear conclusion. C-reactive protein (C.reactiveprotein, CRP) is considered as an important biological marker of the process of inflammatory response. Studies shew that CRP elevation was a strong risk factor acute coronary events, and had significant value in the evaluation and prognosis of unstable angina.Plasma hs-CRP (high sensitivity C-reative protein)had high sensitivity and accuracy as a inflammatory cytokine. Von Willebrand factor (vWF) is one of the major glycoprotein to stop bleeding and thrombosis.Plasma vWF is mainly synthesized by Weibel-pallade body of endothelial cells. when the endothelial cells are damaged ,vWF is released into the blood.Afte released into the blood,vWF mediates platelet adhesion and combine with clotting factor VI to promote the formation of thrombosis. As a specific indicator of vascular endothelial cell damage and the process of thrombosis, more and more information of the relation between vWF and coronary heart disease has been found.ObjectiveTo detect the serum levels of hsCRP and vWF in patients with different types of CHD.To explore the correlation between hsCRP,vWF and the extent stability of their disease. To study their possible mechanism and provide a theoretical basis for clinical intervention.Methods87 cases of patients with coronary artery disease were divided into three groups randomly according to their respective diagnostic criteria. 27 patients in stable angina (SAP) group,42 patients in unstable angina pectoris (UAP) group, 18 patients in acute myocardial infarction (AMI) group.25 persons with normal of normal coronary angiography control group. hs-CRP, vWF levels were determinated by enzyme-linked immunosorbent assay (ELISA). Gensini score system was used to evaluate the severtiy of CHD.Results1.No significant differences were found in gender,age body mass index,smoking hypertension,diabets family history, blood lipids among the 4 groups (P > 0.05).2. hsCRP, vWF levels were significantly higher in the UAP and AMI group than in the SAP and contol group(5.61±0.85mg/L,118.68±22.72%,7.19±0.82mg/L,134±22.97%vs1.83±0.54mg/L,84.69±20.73%, 1.21±0.60mg/L,69.12±15.46%)respectively (P<0.05).3.Plasma hsCRP, vWF levels and coronary stenosis score was positively correlated in the UA group and AMI group.The correlation coefficient (r) in the UA group were 0.579 (P = 0.021), 0.485 (P= 0.027) respectively, in the AMI group were 0.658 (P = 0.014), 0.694 (P= 0.009) respectively.No corelations were found between hsCRP,Vwf levels and gensini scores in the SAP group, the correlation coefficient (r) were 0.324 (P = 0.212), 0.375 (P= 0.186).Conclusion1. Serum levels of hsCRP, vWF in patients with acute coronary syndrome was significantly higher than in stable angina pectoris Patients and normal subjects.2. Serum hsCRP, vWF levels in patients with coronary artery disease may be indicators of unstability. 3. Serum hsCRP, vWF levels may reflect the degree of coronary artery disease in patients with ACS. |
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