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[目的]通过检测急性心肌梗死(AMI)、不稳定心绞痛(UAP)、稳定心绞痛(SAP)、陈旧性心肌梗死(OMI)、正常人、慢性支气管炎患者的中性粒细胞弹性蛋白酶(NE)浓度,以探讨NE与ACS、冠心病病情严重程度的关系。[方法]根据病史、体检、心电图、胸片、彩色多普勒的结果,139名患者分成ACS组(A组)、冠脉病变稳定状态组(B组),慢性炎症对照组为慢性支气管炎组(C组),正常对照组为正常人组(D组)。ACS患者在发病后24h抽取静脉血,其余患者在入院后立即抽取静脉血,行血常规和肌钙蛋白、肌酸磷酸激酶检查,并立即分离血浆,-40℃保存至检测。PMNElastaseKit试剂盒以酶联免疫吸附检测法(ELISA)检测患者血浆中NE浓度。[结果]①A组NE浓度明显高于B组、C组、D组,差别有统计学意义(χ2=34.503,P﹤0.0001);B、C、D组间差异无统计学意义(P﹥0.05)。②NE浓度与肌钙蛋白、肌酸磷酸激酶、白细胞总数和中性粒细胞百分比值均呈正相关(P﹤0.001),与高血压、糖尿病和高脂血症无相关性(P﹥0.05);同时,A组与C组白细胞总数(WBC)和中性粒细胞百分比值(N)进行比较,两组差异无统计学意义(P﹥0.05)。③比较同一患者在急性期和稳定期所测得NE的浓度,发现急性期组与稳定期组NE浓度差异有统计学意义(t=3.121,P﹤0.005),从而更进一步证实NE浓度在冠心病不稳定期高于稳定期。[结论]血浆NE浓度与急性冠脉病变不稳定状态有相关性,可能是冠状动脉斑块病变不稳定性的炎性标志物之一。
[Objective] To investigate the changes of neutrophil elastase (NE) in patients with acute myocardial infarction (AMI), unstable angina pectoris (UAP), stable angina pectoris (SAP), old myocardial infarction (OMI), normal subjects and chronic bronchitis, Concentration to explore the NE and ACS, coronary heart disease severity of the relationship. [Methods] According to the results of medical history, physical examination, electrocardiogram, chest radiograph and color Doppler, 139 patients were divided into ACS group (group A), stable coronary artery disease group (group B) and chronic inflammation group as chronic bronchitis Group (group C), normal control group was normal group (group D). Venous blood was drawn from patients with ACS at 24h after onset, and venous blood was drawn immediately after admission. Blood samples were taken for venous blood and troponin and creatine phosphokinase. Plasma was immediately separated and stored at -40 ° C for detection. PMNElastaseKit kit for the detection of plasma concentrations of NE in patients with enzyme-linked immunosorbent assay (ELISA). [Results] ① The NE concentration in group A was significantly higher than that in group B, C and D (χ2 = 34.503, P <0.0001). There was no significant difference between groups B, C and D ). (2) There was a positive correlation between NE concentration and troponin, creatine phosphokinase, total number of leukocytes and neutrophil percentage (P <0.001) and no correlation with hypertension, diabetes and hyperlipidemia (P> 0.05) (WBC) and neutrophil percentage (N) in group A and group C, there was no significant difference between the two groups (P> 0.05). ③ Compared NE concentrations measured in acute and stable patients in the same patient, we found there was a significant difference in NE concentration between the acute phase group and the stable phase group (t = 3.121, P <0.005), further confirming the NE concentration in the crown Cardiovascular instability is higher than the stable period. [Conclusion] There is a correlation between the concentration of plasma NE and the unstable state of acute coronary lesion, which may be one of the inflammatory markers of unstable plaque of coronary artery.