血浆白介素-37水平与冠状动脉病变程度的相关性研究  

Correlation between the plasma level of IL--37 and coronary artery disease

作　　者：符灵智 赵蕾[1] 杨晓红[1] 崔炜[1] 李汭傧[1] 崔晓冉 张冀东[1] FU Ling-zhi;ZHAO Lei;YANG Xiao-hong;CUI Wei;LI Rui-bin;CUI Xiao-ran;ZHANG Ji-dong(Department of Cardiology,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院心内科,河北省石家庄市050000

出　　处：《中国心血管病研究》2021年第2期129-133,共5页Chinese Journal of Cardiovascular Research

摘　　要：目的探讨急性冠状动脉综合征(acute cornary syndrome,ACS)患者血浆白介素-37(interleukin-37,IL-37)水平与冠状动脉病变程度的关系。方法选取2016年1~12月因胸闷、胸痛等症状就诊于河北医科大学第二医院并行冠状动脉造影的患者作为研究对象,依据患者的症状、心电图、心肌酶、冠状动脉造影术结果分为对照组稳定型心绞痛组和不稳定型心绞痛患者组以及急性心肌梗死患者组,每组30例。收集血液标本常规检测患者的生化指标,用酶联免疫吸附法(ELISA)检测血浆IL-37和IL-18,行超声心动图明确左心室舒张末径(LVEDD)和左心室射血分数(LVEF),行冠状动脉造影术评估的冠状动脉Gensini评分。结果心肌梗死组的LVEF较对照组、稳定组和不稳定组降低(P<0.05);而心肌梗死组LVEDD、脑钠肽(brain natriuretic peptide,BNP)、肌钙蛋白Ⅰ(cardiac troponinⅠ,cTnⅠ)、Gensini评分和肌酸激酶同工酶(creatine kinase isoenzymes,CK-MB)较对照组、稳定组和不稳定组明显升高(P<0.05)。心肌梗死组的IL-37血浆水平为62.05(58.14,63.12)ng/L,较不稳定组53.57(48.76,57.30)ng/L、对照组34.12(31.77,36.27)ng/L、稳定组36.75(35.35,39.08)ng/L明显升高(P<0.05);心肌梗死组的IL-18血浆水平为799.24(677.54,933.57)ng/L,较不稳定组620.31(445.11,836.27)ng/L、对照组169.42(139.93,185.31)ng/L、稳定组255.14(171.33,327.88)ng/L明显升高(P<0.05);心肌梗死组的CRP血浆水平为16.26(9.98,23.03)mg/L,较不稳定组6.30(1.50,8.95)、对照组3.86(1.47,4.45)mg/L、稳定组2.07(0.66,2.75)mg/L明显升高(P<0.05)。相关性分析显示,L-37浓度与BNP、cTnⅠ、Cr、CK-MB、LVEDD、TC、TG、LDL-C和Gensini评分无明显相关,与CRP之间具有正相关性(r=0.532,P<0.01),与LVEF之间具有负相关性(r=-0.442,P<0.01),与IL-18具有正相关性(r=0.808,P<0.01)。结论冠心病患者血浆IL-37明显升高,提示IL-37可能成为ACS患者诊断和预后的-种新型标志物。Objective To investigate the relationship between the plasma levels of interleukin-37(IL-37)and coronary artery disease.Methods Patients with chest tightness and chest pain or other symptoms who underwent coronary angiography were enrolled into this study from January 2016 to December 2016 in the Second Hospital of Hebei Medical University and divided into 4 groups:control group,stable angina,unstable angina and acute myocardial infarction,30 cases each group.All the patients'brain natriuretic peptide(BNP),left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),creatine kinase isoenzymes(CK-MB),creatinine(Cr),cardiac troponin I(cTnI),CRP,total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL)and Gensini score were routinely detected.Enzyme linked immunosorbent assay was used to detect serum IL-37 and IL-18.Results The level of LVEF in the myocardial infarction group was lower than control group,stable angina group and unstable angina group(P<0.05),while the LVEDD,BNP,cTnI,Gensini score and CK-MB were significantly higher than other three groups(P<0.05).The plasma levels of IL-37 in myocardial infarction group were 62.05(58.14,63.12)ng/L,higher than 53.57(48.76,57.30)ng/L in unstable angina group,34.12(31.77,36.27)ng/L in angina group and 36.75(35.35,39.08)ng/L in control group(P<0.05).The plasma levels of IL-18 in myocardial infarction group were 799.24(677.54,933.57)ng/L,higher than 620.31(445.11,836.27)ng/L in unstable angina group,255.14(171.33,327.88)ng/L in angina group and 169.42(139.93,185.31)ng/L in control group(P<0.05).The plasma levels of CRP in myocardial infarction group were 16.26(9.98,23.03)mg/L,higher than 6.30(1.50,8.95)mg/L in unstable angina group,2.07(0.66,2.75)mg/L in angina group and 3.86(1.47,4.45)mg/L in control group(P<0.05).Correlation analysis showed that the concentration of IL-37 had no significant correlation with BNP,cTnI,CK-MB,LVEDD,Cr,TC,TG,LDL and Gensini score,but a positive correlation with IL-18 and CRP(r=0.808,0.532,P<0.01)and a neg

关 键 词：急性冠状动脉综合征 白介素-37 白介素-18 C-反应蛋白 

分 类 号：R541.4[医药卫生—心血管疾病]