Evaluation of markers of endothelial damage in cases of young myocardial infarction
Evaluation of markers of endothelial damage in cases of young myocardial infarction
复制标题
DOI：
10.1016/j.atherosclerosis.2004.12.040
复制
发表时间：
2005-06-01
期刊：
影响因子：
5.3
通讯作者：
Chatterjee, S
中科院分区：
文献类型：
--
作者：
Khare, A;Shetty, S;Chatterjee, S
动脉血栓性疾病的发病机制涉及多种与动脉粥样硬化和血栓形成相关的遗传和环境因素。内皮是单层多边形细胞，在整个血管系统的管腔表面上连续延伸。内皮损伤导致功能障碍。损伤的原因包括脂质、免疫复合物、微生物、吸烟、高血压、衰老、糖尿病和创伤。已有研究评价了内皮细胞膜上不同粘附分子在动脉粥样硬化发病机制中的作用。这些分子是细胞间粘附分子1型（ICAM-1）、血管细胞粘附分子1型（VCAM-1）、血小板/内皮细胞粘附分子1型（PECAM-1）、可溶性P-选择素（sP-选择素）和可溶性E-选择素（sE-选择素）。从孟买KEM医院心脏病科门诊招募120例心肌梗死患者（年龄40岁以下）。所有患者均在MI稳定后8-10周招募。检测血清sP-选择素、sE-选择素、sPECAM-1及同型半胱氨酸水平。健康的年龄和性别匹配的控制和家庭控制也在本研究中招募。sP-选择素、sE-选择素和sPECAM-1的水平在病例中与对照相比没有显著差异（p > 0.05）。与对照组相比，高同型半胱氨酸血症与MI显著相关（P < 0.001），比值比为6.26（95%置信限3.11-12.76）。叶酸能够纠正高同型半胱氨酸血症在绝大多数情况下。叶酸治疗后sP-选择素、sE-选择素和sPECAM-1水平均降低，但仅sE-选择素水平显著降低（p < 0.05）。因此，叶酸具有双重作用，因为它降低了高同型半胱氨酸血症和sE-选择素，这表明叶酸补充15天后显著降低。(c)2005爱思唯尔爱尔兰有限公司保留所有权利。
The pathogenesis of arterial thrombotic disease involves multiple genetic and environmental factors related to atherosclerosis and thrombosis. The endothelium is a monolayer of polygonal cells that extend continuously over the luminal surface of the entire vasculature. Injury to the endothelium leads to dysfunction. The causes of injury include lipids, immune complexes, microorganisms, smoking, hypertension, aging, diabetes mellitus and trauma. Studies have been done to evaluate the role of different adhesion molecules on the endothelial membrane in the pathogenesis of atherosclerosis. These molecules are intercellular adhesion molecule type-1 (ICAM-1), vascular cell adhesion molecule type-1 (VCAM-1), platelet/endothelial cell adhesion molecule-1 (PECAM-1), soluble P-selectin (sP-selectin) and soluble E-selectin (sE-selectin). One-hundred and twenty patients of myocardial infarction (age below 40 years) were recruited from the out-patients department of Department of Cardiology, KEM Hospital, Mumbai. All the patients were recruited 8-10 weeks after stabilization after MI. We estimated the levels of sP-selectin, sE-selectin, sPECAM-1 and serum homocysteine. Healthy age and sex-matched controls and family controls were also recruited in the present study. The levels of sP-selectin, sE-selectin and sPECAM-1 did not differ significantly in cases as compared to controls (p > 0.05). Hyperhomocysteinemia was significantly associated with MI in comparison with controls (P < 0.001) with an odds ratio of 6.26 (95% confidence limits 3.11-12.76). Folic acid was able to correct hyperhomocysteinemia in a large majority of the cases. Although the levels of sP-selectin, sE-selectin and sPECAM-1 decreased after folic acid therapy, it was only sE-selectin which was significantly reduced (p < 0.05). Thus, folic acid had a dual effect in that it reduced hyperhomocysteinemia and sE-selectin which showed a significant reduction on folate supplementation for 15 days. (c) 2005 Elsevier Ireland Ltd. All rights reserved.