血清C-反应蛋白、可溶性CD40配体、基质金属蛋白酶-2水平与冠心病的相关性  

The study of correlation between the levels of serum CRP、sCD40L、MMP-2 and coronary heart disease

作　　者：马腾[1] 吴继雄[2] 孙昕[3] 

机构地区：[1]安徽省立医院心血管内科,合肥230000 [2]安徽医科大学第一附属医院心血管内科 [3]安徽医科大学第一附属医院中心实验室

出　　处：《临床心血管病杂志》2007年第3期170-173,共4页Journal of Clinical Cardiology

摘　　要：目的:观察不同类型冠心病(CHD)患者血清中C-反应蛋白(CRP)、可溶性细胞分化抗原40配体(sCD40L)、基质金属蛋白酶-2(MMP-2)水平的变化情况,探讨炎性指标与冠状动脉狭窄程度之间的关系及与急性冠状动脉综合征(ACS)间的关系。方法:选取CHD患者65例,包括稳定型心绞痛(SAP)组21例、不稳定型心绞痛(UAP)组22例、急性心肌梗死(AMI)组22例。按Gensini评分法评定其冠状动脉狭窄程度。另16例冠状动脉造影正常者列为对照组。结果:UAP组和AMI组的血清CRP水平均均明显高于SAP组和对照组(均P<0.01),SAP组与对照组差异无统计学意义(P>0.05),AMI组较UAP组明显增高(P<0.01);血清sCD40L水平在对照组、SAP组、UAP组、AMI组逐渐增高,其中AMI组和UAP组较SAP组和对照组的差异有统计学意义(均P<0.01),而在AMI组和UAP组之间以及SAP组和对照组之间,差异无统计学意义(P>0.05);血清MMP-2水平在对照组、SAP组、UAP组、AMI组逐渐升高,且各组间均差异有统计学意义(均P<0.01)。这3个指标与冠状动脉狭窄程度间无相关性(P>0.05)。多元Logistic逐步回归分析显示CRP的风险比值(OR)为1.452,P<0.05;sCD40L的OR值为1.071,P>0.05;MMP-2的OR值为1.152,P<0.05。结论:血清CRP、sCD40L、MMP-2水平能反映CHD的严重程度,并可间接反映冠状动脉斑块的稳定性。CRP、MMP-2可能是ACS发生发展的重要危险因子。Objective.. This study is designed to investigate the difference of peripheral serum CRP. sCD40L, MMP-2 levels in different subtype of coronary heart disease（CHD）, and to explore the relationship between inflammatory markers and the severity of coronary stenosis,and the correlation between them and the incidence of acute coronary syndrome（ACS）. Method： Sixty-five patients with CHD were divided into stable angina pectoris （SAP） group（21 patients）.unstable angina pectoris（UAP） group（22 patients）.acute myocardial infarction（AMI） group（22 patients）,SAP and UAP were documented by coronary angiography, the severity of coronary stenosis was graded with Gensini score, 16 subjects who underwent coronary angiography but showed no evidence of CHD served as normal control, peripheral serum CRP .sCD40L and MMP-2 levels were measured by ELISA. Result： Compared the control with SAP, serum CRP level was markedly increased in UAP and AMI patients（P〈0. 01）, and no significant difference was found between SAP group and the control,in the patients with AMI,the level of CRP was higher than the patients with UAP;Serum sCD40L was increased stepwise according to the sequences of the control. SAP. UAP and AMI. The patients with UAP and AMI had significantly raised serum levels of sCD40L when compared with the patients with SAP and the control（P〈0.01）, but no significant difference was found between AMI group and UAP group and between SAP group and the control;The concentrations of MMP- 2 were elevated stepwise according to the sequences of the control.SAP.UAP and AMI, also marked differences among all groups（P〈0. 05）. There was no correlation between the severity of coronary stenosis and the levels of the inflammatory mediators. Logistic stepwise regression analysis revealed that the odds ratio（OR） of both CRP and MMP-2 was〉l（P〈0. 05）,indicating that CRP and MMP-2 were important risk factors. Conclusion： Serum levels of CRP,sCD40L, MMP-2 may reflect the severity of CHD a

关 键 词：冠状动脉疾病 炎症 C-反应蛋白 细胞分化抗原40配体 基质金属蛋白酶-2 

分 类 号：R541.4[医药卫生—心血管疾病]