人类巨细胞病毒感染与急性冠脉综合症患者血清炎症介质的相关性研究  

Relationship between Human Cytomegalovirus Infection and Serum Inflammatory Mediators in Patients with Acute Coronary Syndrome

作　　者：周小明 邓桂明 龙云 刘建和 吴亦之 谭琦 ZHOU Xiao-ming;DENG Gui-ming;LONG Yun;LIU Jian-he;WU Yi-zhi;TAN Qi(Department of Internal Medicine-Cardiovascular,The First Affiliated Hospital of Hunan University of traditional Chinese Medicine,Changsha,Hunan,410007,China)

机构地区：[1]湖南中药大学第一附属医院心内科,湖南长沙410007

出　　处：《现代生物医学进展》2020年第4期776-779,共4页Progress in Modern Biomedicine

基　　金：教育部重点实验室开放基金项目(ZYNK201702)。

摘　　要：目的:分析人类巨细胞病毒(HCMV)感染与急性冠脉综合症(ACS)患者炎症介质的相关性,探讨HCMV感染在ACS发生、发展过程中的作用。方法:选取我院2017年5月~2019年5月收治的冠心病患者118例,根据病情将其分为ACS组(n=81)和稳定型心绞痛(SAP)组(n=37),另选取同时期在我院进行健康检查的健康志愿者40例作为对照组。检测所有受试者血清特异性HCMV-Ig G、HCMV-Ig M,比较所有受试者血清sP-选择素(sP-selectin)、肿瘤坏死因子-α(TNF-α)及超敏C-反应蛋白(hs-CRP)水平。分析ACS组患者血清sP-selectin、TNF-α、hs-CRP水平与HCMV-Ig M抗体滴度的相关性。结果:ACS组、SAP组的HCMV-Ig G阳性率分别为81.48%、78.38%,均明显高于对照组的45.00%,差异有统计学意义(P<0.05)。ACS组的HCMV-Ig M阳性率为40.74%,明显高于SAP组的10.81%和对照组的5.00%,差异有统计学意义(P<0.05)。ACS组患者血清sP-selectin、TNF-α及hs-CRP水平均明显高于SAP组和对照组,差异有统计学意义(P<0.05)。ACS组HCMV-Ig M阳性患者血清sP-selectin、TNF-α及hs-CRP水平均明显高于HCMV-Ig M阴性患者,差异有统计学意义(P<0.05)。ACS组患者血清sP-selectin、TNF-α、hs-CRP水平与HCMV-Ig M抗体滴度均呈正相关(P<0.05)。结论:慢性HCMV感染可能在动脉粥样硬化的发生及发展中起着重要作用,而急性HCMV感染可能通过上调机体sP-selectin、TNF-α、hs-CRP等炎症因子水平,进一步促进ACS的发生发展。Objective: To analyze the correlation between human cytomegalovirus(HCMV) infection and the inflammatory mediators of patients with acute coronary syndrome(ACS), and explore the role of HCMV infection in the occurrence and development of ACS. Methods: 118 cases of coronary heart disease patients who were admitted to our hospital from May 2017 to May 2019 were selected,and they were divided into ACS group(n=81) and stable angina pectoris(SAP) group(n=37) according to illness condition, another 40 healthy volunteers in our hospital who were selected as control group during the same period. The serum specific HCMV-Ig G and HCMV-Ig M were detected in all subjects, and the levels of serum sP-selectin, tumor necrosis factor-α(TNF-α) and high sensitivity C-reactive protein(hs-CRP) were compared in all subjects. The correlation between serum sP-selectin, TNF-α and hs-CRP levels and the titer of HCMV-Ig M antibody in patients of ACS group were analyzed. Results: The positive rates of HCMV-Ig G in the ACS group and in the SAP group were 81.48% and 78.38% respectively, which were significantly higher than 45.00% in the control group, and the differences were statistically significant(P<0.05). The positive rate of HCMV-Ig M in the ACS group was 40.74%, which was significantly higher than 10.81% in the SAP group and 5.00% in the control group, and the differences were statistically significant(P<0.05). The levels of serum sP-selectin, TNF-α and hs-CRP in the ACS group were significantly higher than those in the SAP group and in the control group, and the differences were statistically significant(P<0.05). The levels of serum serum sP-selectin, TNF-α and hs-CRP in patients with HCMV-IgM positive in the ACS group were significantly higher than those in patients with HCMV-Ig M negative, and the differences were statistically significant(P<0.05). The levels of serum sP-selectin, TNF-α, hs-CRP in the ACS group were positively correlated with the titer of HCMV-IgM antibody(P<0.05). Conclusion: Chronic HCMV infection may play

关 键 词：人类巨细胞病毒 感染 急性冠脉综合症 SP-选择素 肿瘤坏死因子-α 超敏C-反应蛋白 

分 类 号：R541.4[医药卫生—心血管疾病] R373[医药卫生—内科学]