血浆炎症细胞因子与急性冠脉综合征的相关性研究  

Relationship between plasma inflammatory cytokines and acute coronary syndrome

作　　者：任广理[1] 罗涛[2] 侯伯轩[1] 丁鹏[1] 浦奎[2] REN Guang-li;LUO Tao;HOU Bo-xuan;DING Peng;PU Kui(Department of Anesthesia, Chinese PLA 254 Hospital, Tianjin 300142, China)

机构地区：[1]中国人民解放军第254医院麻醉科,天津300142 [2]中国人民解放军第254医院,天津300142

出　　处：《中国循证心血管医学杂志》2017年第3期360-364,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的通过对不同临床类型冠状动脉粥样硬化性心脏病(冠心病,CHD)患者血浆炎症细胞因子白介素-17(IL-17)、白介素-6(IL-6)、高敏C反应蛋白(hs-CRP)浓度的测定及比较,分析炎症细胞因子在急性冠脉综合征(ACS)发生发展过程中的作用及临床意义,并探讨IL-17与Gensini积分相关性。方法选择2014年7月~2015年1月于解放军第254医院住院的拟诊CHD患者114例,并分成3组:急性冠脉综合征组(ACS组,61例)、稳定心绞痛组(SAP组,29例)和对照组(24例)。其中,ACS组进一步分为两个亚组:急性心肌梗死组(AMI组,30例)和不稳定心绞痛组(UAP组,31例)。采用酶联免疫吸附试验(ELISA)法分别检测四组患者IL-17、IL-6、hs-CRP浓度。采用Gensini评分系统评价冠状动脉严重程度,分析IL-17与Gensini评分的关系。结果对照组高密度脂蛋白高于SAP、UAP及AMI组,而低密度脂蛋白、总胆固醇、三酰甘油、尿酸低于SAP、UAP及AMI组(P<0.05)。ACS组血浆IL-17、IL-6、hs-CRP表达高于对照组和SAP组(P<0.01);AMI组血浆IL-17、IL-6、hs-CRP表达高于UAP组(P<0.01);SAP组血浆IL-17、IL-6表达高于对照组(P<0.01);对照组和SAP组血浆hs-CRP表达浓度无统计学差异(P>0.05)。经直线相关与回归分析,IL-17、IL-6、hs-CRP表达水平两两呈正相关,相关系数(r)分别为0.572、0.496、0.468(P<0.05)。IL-17与Gensini评分呈正相关(r=0.671,P<0.05)。结论 IL-17、IL-6、hs-CRP与动脉粥样硬化(AS)形成和斑块不稳定密切相关。血浆IL-17与Gensini评分呈正相关,可能是评价ACS冠状动脉病变程度的有用指标。IL-17、IL-6、hs-CRP之间存在正相关性,表明炎症细胞因子之间存在着复杂的网状联系,共同促进动脉粥样硬化的形成和CHD的进展。Objective To analyze the effect and clinical significance of inflammatory cytokines in occurrence and development of acute coronary syndrome (ACS) through detecting and comparing the levels of plasma inflammatory cytokines including interleukin-17 (IL-17), interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) in patients with different types of coronary heart disease (CHD), and discuss the correlation between IL-17 and Gensini integral. Methods CHD patients (n=114) were chosen from the Chinese PLA 254 Hospital from July 2014 to June 2015,and divided into ACS group (n=61), stable angina pectoris group (SAP group, n=29) and control group (n=24). ACS group was further divided into subgroup of acute myocardial infarction group (AMI subgroup, n=30) and subgroup of unstable angina pectoris (UAP subgroup, n=31). The levels of IL-17, IL-6 and hs-CRP were detected by using enzyme-linked immunosorbent assay (ELISA). The severity of coronary lesions was reviewed by using Gensini scoring system, and relationship between IL-17 and Gensini score was analyzed. Results The level of high-density lipoprotein (HDL) was higher, and levels of low-density lipoprotein (LDL), total cholesterol (TC), triglyceride (TG) and uric acid (UA) were lower in control group than those in SAP group, UAP subgroup and AMI subgroup (P<0.05). The expressions of plasma IL-17,IL-6 and hs-CRP were higher in ACS group than those in control group and SAP group (P<0.01). The expressions of plasma IL-17, IL-6 and hs-CRP were higher in AMI subgroup than those in UAP subgroup (P<0.01). The expressions of plasma IL-17 and IL-6 were higher in SAP group than those in control group (P<0.01). The expression of plasma hs-CRP had no statistical difference between control group and SAP group (P>0.05). The linear correlation and regression analysis showed that expressions of IL-17, IL-6 and hs-CRP were pairwise correlated positively (r=0.572, r=0.496, r=0.468,P<0.05). The level of IL-17 was positively correlated to Gensini score (r=0.671, P<0.05). Conclu

关 键 词：急性冠脉综合征 白介素-17 白介素-6 高敏C反应蛋白 

分 类 号：R541.4[医药卫生—心血管疾病]