急性冠状动脉综合征患者机体炎症反应程度的评估及苯那普利的干预作用研究  

Evaluation of inflammation degree in patients with acute coronary syndrome and intervening effect of benazepril

作　　者：莫艳霞[1] 

机构地区：[1]长江大学附属仙桃市第一人民医院心血管内科,湖北仙桃433000

出　　处：《海南医学院学报》2016年第4期332-335,339,共5页Journal of Hainan Medical University

基　　金：湖北省继续教育项目(2013-08-01-109)~~

摘　　要：目的:研究急性冠状动脉综合征患者的炎症反应程度及苯那普利的干预作用。方法:选择在长江大学附属仙桃市第一人民医院体检的30例健康者纳入研究的健康对照组,稳定型心绞痛患者30例纳入SAP组,不稳定型心绞痛患者30例纳入UAP组,非ST段抬高型心肌梗死患者30例纳入USTEMI组,ST段抬高型心肌梗死患者30例纳入STEMI组,检测外周血中TLR4的表达量以及血清中TNF-α、IL-1β、IL-6、MMP-2、MMP-9、VCAM-1、ICAM-1、ILAM-1、sCD40L、MCP-1的含量。结果:5组受试者外周血单个核细胞中TLR4的表达量以及血清中TNF-α、IL-1β、IL-6、MMP-2、MMP-9、VCAM-1、ICAM-1、ILAM-1、sCD40L、MCP-1的含量有差异;ACS患者的病情越严重,外周血单个核细胞中TLR4的表达量以及血清中TNF-α、IL-1β、IL-6、MMP-2、MMP-9、VCAM-1、ICAM-1、ILAM-1、sCD40L、MCP-1的含量越高,TLR4的表达量与血清中TNF-α、IL-1β、IL-6、MMP-2、MMP-9、VCAM-1、ICAM-1、ILAM-1、sCD40L、MCP-1的含量均呈正相关;苯那普利干预后,STEMI组、USTEMI组、UAP组患者外周血单个核细胞中TLR4的表达量均显著低于干预前。结论:急性冠状动脉综合征患者的炎症反应程度显著增强,TLR4是介导炎症反应的主要上游分子,苯那普利能够有效抑制炎症反应、降低外周血中TLR4的表达量。Objective To study the inflammation degree in patients with acute coronary syndrome and the intervening effect of benazepril. Methods A total of 30 healthy volunteers receiving physical examination were enrolled as healthy control group, 30 cases with stable angina pectoris were enrolled in SAP group, 30 cases with unstable angina pectoris were enrolled in UAP group, 30 cases with non-ST segment elevation myocardial infarction were enrolled in USTEMI group, 30 cases with ST segment elevation myocardial infarction were enrolled in STEMI group. Then TLR4 expression levels in peripheral blood as well as TNF-α, IL-1β, IL 6, MMP-2, MMP-9, VCAM-1, ICAM-1, ILAM-1, sCD40I, and MCP-1 contents in serum were detected. Results= TLR4 expression levels in peripheral blood mononuclear cells as well as TNF-α, IL-1β, IL-6, MMP-2, MMP- 9, VCAM-1, ICAM-1, ILAM-1, sCD40L and MCP 1 contents in serum of five groups had differences; the more severe the ACS, the higher the TLR4 expression level in peripheral blood mononuclear cells as well as TNF-α, IL-1β, IL-6, MMP-2,MMP-9, VCAM-1, ICAM-1, ILAM-1, sCD40L and MCP-1 contents in serum, and TLR4 expression level was positively cor- related with serum TNF-α, IL-113, IL-6, MMP 2, MMP-9, VCAM-1, ICAM-1, ILAM-1, sCD40L and MCP-1 contents after benazepril intervention, TLR4 expression levels in peripheral blood mononuclear cells of STEMI group, USTEMI group and UAP group were significantly lower than those before intervention. Conclusion： The inflammation degree in patients with acute coronary syndrome is significantly enhanced. TLR4 is the main upstream molecule mediating inflammation, and henazepril can effectively inhibit inflammation and reduce TLR4 expression level in peripheral blood.

关 键 词：急性冠状动脉综合征 TOLL样受体4 炎症反应 苯那普利 

分 类 号：R541.4[医药卫生—心血管疾病]