血清血管内皮生长因子在不同类型冠心病的差异分析

发布时间：2018-04-10 17:27

  本文选题：冠状动脉疾病 + 血管内皮生长因子　； 参考：《华北理工大学》2017年硕士论文

【摘要】：目的通过分析不同类型冠心病患者血清中VEGF的水平,总结VEGF在冠心病不同患者人群中的差异,从而为VEGF在冠心病的临床诊疗中应用提供线索。方法本研究属于随机区组病例对照研究。收集2016年01月-2017年1月就诊于本院心内科的冠心病患者149例,其中冠脉血管非闭塞病变患者共33例,冠脉血管闭塞性病变患者共64例,冠脉血管和/或血运重建患者共52例。收集入组患者临床基本资料,通过ELISA Kit法检测患者血清VEGF值。1对上述三组患者临床资料及VEGF值进行分析。2将所有入组患者按冠心病不同类型,分为NSTE-ACS组、STEMI组、OMI组、PCI术后组、CABG术后组,分析五组VEGF值的差异。3将患者按NYHA分级,重新分为A组:心功能Ⅰ、Ⅱ级患者,B组:心功能不全Ⅲ、Ⅳ级,对A、B组患者VEGF水平进行分析。4按照NYHA分级,将患者分为心功能Ⅰ级组、心功能Ⅱ级组、心功能Ⅲ组及心功能Ⅳ组,比较四组患者VEGF值。5随访6个月,观察患者再发心绞痛、心肌梗塞、心衰及心源性死亡二级终点事件发生率,探讨VEGF浓度与患者冠心病预后的关系。结果1冠状动脉血管闭塞组VEGF均值为164.23pg/ml,95%置信区间为(142.66,185.80)明显高于冠状动脉非闭塞组、冠状动脉血管和/或血运重建组,差异有统计学意义(P0.05)。2 STEMI组VEGF值OMI组CABG术后组NSTEACS组PCI术后组,且除NSTE-ACS组与PCI术后组、OMI组与GABG术后组外,其他任意两组间均有统计学意义(P0.05)。3 B组患者VEGF均值高于A组患者,分别为128.9pg/ml和109.44pg/ml。但是两组间进行方差分析,差异无统计学意义(P0.05)。4心功能Ⅲ级患者VEGF值心功能Ⅱ级患者心功能Ⅳ级患者心功能Ⅰ级患者。除心功能Ⅰ级组VEGF值与心功能Ⅳ级组差异无统计学意义,其余各组间均有明显统计学差异(P0.05)。5对入组149例患者进行6个月随访,观察并记录到患者再发心绞痛、心肌梗塞、心衰及心源性死亡二级终点事件共13人。心功能Ⅳ级的患者发生终点事件为5人,占该组总人数50%。再发心绞痛患者VEGF值较高,而心衰、心源性死亡患者VEGF值偏低。结论1冠状动脉血管闭塞组患者心肌血供不足,缺氧诱导因子刺激VEGF生成,VEGF明显升高反映冠脉缺血严重。2 VEGF可反映冠脉病变的严重程度。3冠心病患者中,轻-中度心功能不全,VEGF水平偏高。没有心功能不全或重度心衰患者,VEGF水平较低。因此,根据冠心病患者病史,可以判断患者有无重度心衰。4冠心病重度心衰患者,VEGF水平偏低,预后较差。
[Abstract]:Objective to analyze the level of VEGF in serum of patients with coronary heart disease (CHD) and to summarize the difference of VEGF in different patients with coronary heart disease (CHD) so as to provide clues for the clinical application of VEGF in the diagnosis and treatment of coronary heart disease (CHD).Methods this study was a randomized case-control study.From January 2016 to January 2017, 149 patients with coronary heart disease were collected, including 33 patients with non-occlusive coronary artery disease, 64 patients with coronary artery occlusive disease and 52 patients with coronary artery and / or revascularization.The basic clinical data of the patients were collected and the clinical data and VEGF value of the three groups were analyzed by ELISA Kit method. 2. All the patients were divided into different types of coronary heart disease.The patients were divided into NSTE-ACS group and NSTE-ACS group. The difference of VEGF value in five groups was analyzed. According to the NYHA grade, the patients were divided into two groups: group A: heart function 鈪，

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