Role of soluble and platelet-bound P-selectin in discriminating cardiac from noncardiac chest pain at presentation in the emergency department.
Role of soluble and platelet-bound P-selectin in discriminating cardiac from noncardiac chest pain at presentation in the emergency department.
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可溶性和血小板结合的 P-选择素在急诊科就诊时区分心源性胸痛和非心源性胸痛的作用。
DOI：
10.1016/s0002-8703(00)90242-4
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发表时间：
2000
影响因子：
4.8
通讯作者：
V. Serebruany
中科院分区：
文献类型：
--
作者：
P. Gurbel;D. Kereiakes;M. Dalesandro;R. Bahr;C. O'connor;V. Serebruany
背景 据报道，选择素通过调节血小板-白细胞-内皮相互作用参与急性冠状动脉综合征的发病机制。在心肌缺血和再灌注的临床环境中也观察到 P-选择素水平升高；然而，其在区分心源性胸痛和非心源性胸痛方面的作用尚不清楚。方法和结果测量了 122 名胸痛患者和 14 名健康对照者的 P-选择素可溶性和血小板分数。与对照组的 P-选择素谱 (102.6 ± 29.0 ng/mL，102.6 ± 29.0 ng/mL， 4.1% ± 1.2% 阳性）和非心源性胸痛患者（114.7 ± 36.6 ng/mL，5.7% ± 2.9% 阳性）。膜阳性率为 10%，可溶性 P-选择素阳性率为 120 ng/mL，灵敏度分别为 0.442 和 0.558，特异性分别为 0.915 和 0.553。结论 当患者到达急诊科时，膜 P-选择素的测量可作为检测血小板活性升高的附加诊断工具，这种活性在心源性胸痛患者中最为常见。然而，低敏感性限制了仅使用 P-选择素谱在胸痛患者总体中适当区分急性冠状动脉综合征的用途。
Background It has been reported that selectins participate in the pathogenesis of acute coronary syndromes by modulating platelet-leukocyte-endothelium interactions. Elevated P-selectin level also has been observed in the clinical setting of myocardial ischemia and reperfusion; however, its utility in differentiating cardiac from noncardiac origins of chest pain is unknown. Methods and Results Soluble and platelet fractions of P-selectin were measured for 122 patients with chest pain and 14 healthy persons acting as controls. Patients with a cardiac problem (unstable angina, congestive heart failure, acute myocardial infarction) had significantly elevated levels of soluble P-selectin (156.0 ± 58.8 ng/mL, P =.002) and platelet-bound P-selectin (11.7% ± 6.4% positive cells, P =.013) compared with the P-selectin profile among controls (102.6 ± 29.0 ng/mL, 4.1% ± 1.2% positivity) and among patients with noncardiac chest pain (114.7 ± 36.6 ng/mL, 5.7% ± 2.9% positivity). With a cutpoint of 10% positivity for membrane and 120 ng/mL for soluble P-selectin, the sensitivities were 0.442 and 0.558, and the specificities were 0.915 and 0.553. Conclusions When a patient arrives in the emergency department, measurement of membrane P-selectin may serve as an additional diagnostic tool to detect heightened platelet activity, which is most prevalent among patients with a cardiac origin of chest pain. However, low sensitivity limits the utility of the P-selectin profile alone in suitably differentiating acute coronary syndromes within the overall population of patients with chest pain.
MB CK 亚型对心肌梗塞的早期诊断。
DOI：
10.1016/s0009-8981(97)00250-7
发表时间：
1998
期刊：
Clinica chimica acta; international journal of clinical chemistry
影响因子：
--
作者：
Roberts,R
通讯作者：
Roberts,R
影响因子：
20.3
作者：
Ostrovsky, L;King, AJ;Kubes, P
通讯作者：
Kubes, P
稳定型和不稳定型心绞痛患者冠状动脉粥样斑块切除标本中 P-选择素、E-选择素和细胞间粘附分子-1 的表达水平。
DOI：
10.1016/s0002-9149(96)00861-2
发表时间：
1997
期刊：
The American journal of cardiology
影响因子：
--
作者：
Tenaglia,AN;Buda,AJ;Wilkins,RG;Barron,MK;Jeffords,PR;Vo,K;Jordan,MO;Kusnick,BA;Lefer,DJ
通讯作者：
Lefer,DJ