冠心病患者血浆TNF-α与CK-MB、LDH、cTnI水平及冠脉病变的相关性分析  

Relationship between Plasma Level of TNF-α,CK-MB,LDH,and cTnI in Coronary Heart Disease

作　　者：卫娜[1] 李俊男[2] 任俊峰[1] 边云飞[2] 

机构地区：[1]山西医科大学第二医院心内科 [2]山西医科大学第二医院

出　　处：《中西医结合心脑血管病杂志》2012年第4期396-398,共3页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：山西省科技攻关基金资助项目(No.20090311057-4)

摘　　要：目的研究分析冠心病患者血浆肿瘤坏死因子(TNF-α)与冠脉病变及心肌酶学指标的相关性,探讨其临床意义。方法从山西医科大学第二临床医院选取经冠状动脉造影证实为冠心病的患者60例,其中稳定型心绞痛(SA)12例,不稳定型心绞痛(UA)31例,急性心肌梗死(AMI)17例,另设对照组28例。用酶联免疫吸附(ELISA)法测定各组血浆TNF-α浓度,用免疫标记法测定肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)及肌钙蛋白I(cTnI)浓度;Gensini积分法对冠脉狭窄程度进行定量评价,并分析TNF-α与冠脉病变程度的相关性。结果冠心病组血浆TNF-α、CK-MB、LDH浓度显著高于对照组(P<0.05);AMI组TNF-α、CK-MB、LDH、cTnI水平明显高于对照组、SA组和UA组(P<0.01);UA组TNF-α、CK-MB水平明显高于对照组和SA组(P<0.05),LDH水平明显高于SA组(P<0.01),TNF-α水平明显高于对照组(P<0.05),LDH水平明显低于对照组;SA组CK-MB水平与对照组比较差异无统计学意义。Gensini积分与TNF-α呈正相关(P<0.01);AMI组TNF-α与CK-MB、LDH、cTnI呈正相关(P<0.01)。结论冠心病患者血浆TNF-α炎症因子的水平明显升高,随冠脉病变的严重程度增高而增高,提示冠心病患者体内已存在炎症反应,TNF-α在其发病机制中起一定作用,可作为冠心病炎症活性的独立指标。CK-MB、LDH、cTnI反映心肌损伤及坏死的程度,联合评估两种指标的水平对于临床估计冠心病的危险程度具有重要的意义。Objective To study the relationship between plasma tumor necrosis factor-α（TNF-α）,creatine kinase-MB isoenzyme（CK-MB）,lactate dehydrogenase（LDH） and cardiac troponin I（cTnI）in coronary heart disease（CHD）,and to assess the value of TNF-α in predicting types of CHD.Methods Sixty patients（pts） with CHD confirmed by coronary angiography（CAG） were enrolled,and 28 healthy subjects served as control group.CHD group divided into stable angina（SA,n=12）,unstable angina（UA,n=31）,and acute myocardial infarction（AMI,n=17） according to the clinical symptom.The disease history,physical examination,assistant examination,CAG,and other epidemic information were record.The levels of plasma TNF-α were determined by enzyme linked immunosorbent assay.Immunity mark was used to measure the plasma CK-MB,LDH,and cTnI.Gensini score were used for coronary artery stenosis quantitative evaluation.Results The levels of plasma TNF-α,CK-MB,LDH in CHD group were significantly higher than that in control group（P0.05）.The the levels of plasma TNF-α,CK-MB,LDH,and cTnI in AMI group were significantly higher than that in control group,SA group and UA group（P0.01）.The levels of plasma TNF-α and CK-MB in UA group were significantly higher than that in control group and SA group（P0.05）.The level of TNF-α in SA group was higher than that in control group（P0.05）.Spearman correlation analysis showed that the level of plasma TNF-α correlated positively with the levels of plasma CK-MB,LDH,and cTnI in AMI group（P0.01）.There was significant correlation between TNF-α and Gensini score（P0.01）.Conclusion The level of plasma TNF-α in pts with CHD was significantly higher.TNF-α might be an early reflection of the inflammation process of CHD.

关 键 词：冠心病 肿瘤坏死因子 肌酸激酶同工酶 乳酸脱氢酶 肌钙蛋白I 

分 类 号：R541.4[医药卫生—心血管疾病] R256.2[医药卫生—内科学]