急性冠脉综合征与血浆蛋白Z及炎症标志物的相关性研究  

The relation study of acute coronary syndrome, plasma protein Z and inflammatory markers

作　　者：傅强[1] 黄丹[2] 王东旺[1] 陈运和[1] 陈宁南[1] 唐斌[1] 

机构地区：[1]江西省人民医院急诊科,江西南昌330006 [2]南昌大学第二附属医院麻醉科,江西南昌330006

出　　处：《中国现代医生》2014年第32期19-21,24,共4页China Modern Doctor

基　　金：江西省卫生厅科技计划(20093004)

摘　　要：目的探讨急性冠脉综合征与血浆蛋白Z(PZ)及炎症标志物的相关性与临床意义。方法筛选100例急性冠脉综合征(ACS)患者,其中急性心肌梗死(AMI)组55例,不稳定型心绞痛(UAP)组45例;50例正常对照者。按试剂盒方法测定PZ和炎症标志物水平。结果 ACS组血清PZ、PPAR-α显著低于正常对照组(P<0.01),而hs-CRP、TNF-α、IL-6、IL-8水平显著高于正常对照组(P<0.01);AMI组PZ、PPAR-α水平低于UAP组,hs-CRP、IL-6水平高于UAP组,但差异无统计学意义(P>0.05)。AMI组TNF-α、IL-8水平明显高于UAP组(P<0.05)。PZ、PPAR-α的表达水平与hs-CRP、TNF-α、IL-6、IL-8呈负相关(r=-0.445、-0.398、-0.534、-0.321;-0.365、-0.511、-0.423、-0.396,P<0.01)。结论急性冠脉综合征患者血浆PZ水平明显下降,提示PZ缺乏可能是急性冠脉综合征存在的一个危险因素。PPAR-α表达明显下调,与明显上升的hs-CRP、TNF-α、IL-6、IL-8呈负相关,提示PPAR-α可能通过抗炎反应,hs-CRP、TNF-α、IL-6、IL-8等可能参与促炎反应参与急性冠脉综合征发病过程,并与斑块的不稳定状态有关。Objective To study the relation and clinical significance between inflammatory markers, plasma protein Z levels and acute coronary syndrome（ACS）. Methods One hundred acute coronary syndrome （ACS） patients, which was comprised of 55 patients with acute myocardial infarction （AMI） and 45 patients with unstable angina pectoris （UAP）, and 50 normal control cases were recruited for this study. The levels of PZ and inflammatory markers were measured according to the kit method. Results The PZ, PPAR-α levels of ACS group were significantly lower than that of the control group （P〈0.01）, while the hs-CRP, TNF-ct, IL-6, IL-8 levels were significantly higher （P〈0.01）. The PZ, PPAR-α levels of AMI group were lower than that of the UAP group, while the hs-CRP, IL-6 levels were higher, but without significant difference（P〉0.05）, the TNF-α, IL-8 levels were significantly higher than that of the UAP group （P〈0.05）. There were significantly inversely correlation between the expression levels of PZ, PPAR-α and hs-CRP, TNF-α, TL-6, TL-8 （r=-0.445, -0.398, -0.534, -0.321; -0.365, -0.511, -0.423, -0.396, P〈0.01）. Conclusion Plasma levels of PZ significantly decreased in patients with ACS, which suggested that PZ deficiency is likely to be a risk factor. PPAR-α expression decreased, which is negative correlated with the expression of hs-CRP, TNF-α, IL-6, IL-8, suggest that it may have anti-inflammatory in the process of ACS, and hs-CRP, TNF-α, TL-6, IL-8 may participate in proinflammatory reactions involved in the onset of ACS process, and they are associated with unstable state of plaque.

关 键 词：急性冠脉综合征 血浆蛋白Z 炎症 

分 类 号：R541.4[医药卫生—心血管疾病]