本文選題：冠狀動脈疾病 + 血管內(nèi)皮生長因子��； 參考：《華北理工大學(xué)》2017年碩士論文

【摘要】：目的通過分析不同類型冠心病患者血清中VEGF的水平,總結(jié)VEGF在冠心病不同患者人群中的差異,從而為VEGF在冠心病的臨床診療中應(yīng)用提供線索。方法本研究屬于隨機區(qū)組病例對照研究。收集2016年01月-2017年1月就診于本院心內(nèi)科的冠心病患者149例,其中冠脈血管非閉塞病變患者共33例,冠脈血管閉塞性病變患者共64例,冠脈血管和/或血運重建患者共52例。收集入組患者臨床基本資料,通過ELISA Kit法檢測患者血清VEGF值。1對上述三組患者臨床資料及VEGF值進(jìn)行分析。2將所有入組患者按冠心病不同類型,分為NSTE-ACS組、STEMI組、OMI組、PCI術(shù)后組、CABG術(shù)后組,分析五組VEGF值的差異。3將患者按NYHA分級,重新分為A組:心功能Ⅰ、Ⅱ級患者,B組:心功能不全Ⅲ、Ⅳ級,對A、B組患者VEGF水平進(jìn)行分析。4按照NYHA分級,將患者分為心功能Ⅰ級組、心功能Ⅱ級組、心功能Ⅲ組及心功能Ⅳ組,比較四組患者VEGF值。5隨訪6個月,觀察患者再發(fā)心絞痛、心肌梗塞、心衰及心源性死亡二級終點事件發(fā)生率,探討VEGF濃度與患者冠心病預(yù)后的關(guān)系。結(jié)果1冠狀動脈血管閉塞組VEGF均值為164.23pg/ml,95%置信區(qū)間為(142.66,185.80)明顯高于冠狀動脈非閉塞組、冠狀動脈血管和/或血運重建組,差異有統(tǒng)計學(xué)意義(P0.05)。2 STEMI組VEGF值OMI組CABG術(shù)后組NSTEACS組PCI術(shù)后組,且除NSTE-ACS組與PCI術(shù)后組、OMI組與GABG術(shù)后組外,其他任意兩組間均有統(tǒng)計學(xué)意義(P0.05)。3 B組患者VEGF均值高于A組患者,分別為128.9pg/ml和109.44pg/ml。但是兩組間進(jìn)行方差分析,差異無統(tǒng)計學(xué)意義(P0.05)。4心功能Ⅲ級患者VEGF值心功能Ⅱ級患者心功能Ⅳ級患者心功能Ⅰ級患者。除心功能Ⅰ級組VEGF值與心功能Ⅳ級組差異無統(tǒng)計學(xué)意義,其余各組間均有明顯統(tǒng)計學(xué)差異(P0.05)。5對入組149例患者進(jìn)行6個月隨訪,觀察并記錄到患者再發(fā)心絞痛、心肌梗塞、心衰及心源性死亡二級終點事件共13人。心功能Ⅳ級的患者發(fā)生終點事件為5人,占該組總?cè)藬?shù)50%。再發(fā)心絞痛患者VEGF值較高,而心衰、心源性死亡患者VEGF值偏低。結(jié)論1冠狀動脈血管閉塞組患者心肌血供不足,缺氧誘導(dǎo)因子刺激VEGF生成,VEGF明顯升高反映冠脈缺血嚴(yán)重。2 VEGF可反映冠脈病變的嚴(yán)重程度。3冠心病患者中,輕-中度心功能不全,VEGF水平偏高。沒有心功能不全或重度心衰患者,VEGF水平較低。因此,根據(jù)冠心病患者病史,可以判斷患者有無重度心衰。4冠心病重度心衰患者,VEGF水平偏低,預(yù)后較差。
[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，

本文編號：1732195