Objective To analyze the profile of dermcidin (DCD) changes in different stages of acute coronary syndrome (ACS) by quantifying the serum 4 183Da DCD peptide fragment deriving from different ACS patients treated with early antithrombotic therapy.Methods A total of 118 patients with confirmed diagnosis of ACS were enrolled. Immediately after visiting a doctor, the venous blood was collected and afterwards instantly the patient was given orally 300 mg of aspirin and 300 mg clopidogrel, and according to the patient's condition and the consent of his/her or acknowledgement of family members achieved, emergency percutaneous coronary interference (PCI) or thrombolysis or conservative treatment was adopted separately. After anti-thrombotic treatment, at 2, 4, 6, 8, 10, 12, 16, 20, 24, 32, 40, 48, 60 and 72 hours, venous blood was collected and serum isolated respectively. The concentration of 4 183Da DCD fragment in serum was determined by matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF-MS). Simultaneously, the myoglobin (Myo), cardiac troponin I (cTnI) and MB isoenzyme of creatine kinase (CK-MB) were also detected.Results The mean relative strength of nature logarithmic transformations of 4 183Da DCD fragment of 118 patients with ACS was 2.75±1.02 before treatment on admission, and after intervention therapy (mainly antithrombotic therapy) it was decreased to 1.84±1.19 (P = 0.005) and 1.74±1.12 (P = 0.000) at 2 hours and 4 hours, respectively, and then after 4 hours it was slightly elevated. 4 183Da polypeptide increased earlier than myocardial injury markers.Conclusion Aspirin and clopidogrel can significantly decrease the concentration of 4 183Da DCD peptide fragment in serum in patients with ACS, which indicates that the DCD fragment could be used as one of the indexes for observation on early efficacy of antithrombotic therapy.%目的 分析急性冠脉综合征(ACS)患者早期抗栓干预治疗后不同时间点血清标本中dermcidin蛋白(也称皮离蛋白)片段4 183Da多肽水平的变化规律.方法 118例确诊的ACS患者于就诊第一时间经静脉取血后即刻嚼服阿司匹林300 mg和氯吡格雷300 mg,并根据病情,在征得患者及家属知情同意后分别采取急诊经皮冠状动脉(冠脉)介入治疗(PCI)或溶栓治疗、内科保守治疗.于抗栓治疗后2、4、6、8、10、12、16、20、24、32、40、48、60、72 h经静脉取血,分离血清,采用基质辅助激光解析离子化飞行时间质谱(MALDI-TOF-MS)技术检测血清dermcidin蛋白片段4 183Da多肽,并检测肌红蛋白(Myo)、肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)水平.结果 118例ACS患者入院就诊时血清dermcidin蛋白片段4 183Da多肽相对强度的自然对数值为2.75±1.02,抗栓治疗后2 h即明显下降为1.84±1.19(P=0.005);4 h为1.74±1.12(P=0.000),4 h后略有回升.4 183Da多肽升高先于心肌损伤标志物.结论 阿司匹林可以显著降低血清dermcidin蛋白片段4 183Da多肽水平,此片段可以作为观察早期抗栓治疗效果的指标之一.
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