论文部分内容阅读
目的探讨血清乙酰肝素酶(HPA)在糖尿病并发急性冠脉综合征(ACS)中的变化及临床意义。方法选取2006年7月至2008年10月北京军区总医院内分泌科28名健康志愿者,27例糖尿病(DM组)患者,52例ACS患者、46例糖尿病并发急性冠脉综合征组(DM+ACS组)进行研究。酶联免疫吸附法(ELISA)检测各组血清C反应蛋白(CRP)、基质金属蛋白酶9、HPA。检测各指标受试者工作特性曲线(ROC),判断并比较血清CRP、MMP-9和HPA检测临界值及检测价值。结果DM+ACS组血清HPA显著高于其他3组(P<0.01);DM+AMI亚组血清HPA显著高于DM+UAP亚组。ROC曲线下面积分别为0.941、0.813和0.967,组间比较差异有统计学意义(P<0.01)。结论血清HPA变化与糖尿病并发急性冠脉综合征发生发展有关,HPA作为预测该类患者动脉粥样斑块不稳定或破裂的血清学指标优于CRP和MMP-9。
Objective To investigate the changes and clinical significance of serum heparanase (HPA) in diabetic patients with acute coronary syndrome (ACS). Methods From July 2006 to October 2008, 28 healthy volunteers, 27 diabetes mellitus patients, 52 ACS patients and 46 diabetes mellitus patients with acute coronary syndrome (DM + ACS group). Serum C-reactive protein (CRP), matrix metalloproteinase 9, and HPA were detected by enzyme linked immunosorbent assay (ELISA). The working characteristic curve (ROC) of each index was detected to determine and compare the serum CRP, MMP-9 and HPA detection threshold and detection value. Results Serum HPA in DM + ACS group was significantly higher than that in the other three groups (P <0.01). Serum HPA in DM + AMI subgroup was significantly higher than that in DM + UAP subgroup. The area under the ROC curve was 0.941,0.813 and 0.967, respectively, with significant difference between the two groups (P <0.01). Conclusions The change of serum HPA is associated with the occurrence and development of diabetes mellitus complicated with acute coronary syndrome. HPA is better than CRP and MMP-9 in predicting the instability or rupture of atherosclerotic plaque in these patients.