【摘要】 目的通过对急性冠状动脉综合征患者血清炎性细胞因子水平的测定及比较,分析炎症及细胞因子在急性冠状动脉综合征发生发展过程中的作用及临床意义。方法选择急性心肌梗死(AMI)患者44例(AMI组),不稳定性心绞痛(UAP)患者44例(UAP组),稳定性心绞痛(SAP)患者43例(SAP组),无冠心病患者35例(对照组),分别检测各组患者血清白细胞介素6(IL-6)、白细胞介素8(IL-8)、白细胞介素10(IL-10)、TNF-α、C反应蛋白(CRP)和基质金属蛋白酶9(MMP-9)浓度并进行比较。结果 AMI组患者血清IL-6、IL-8、IL-10、TNF-α、CRP和MMP-9水平均明显高于SAP组和对照组(P<0.01);AMI组患者血清IL-10、TNF-α、CRP、MMP-9水平明显高于UAP组(P<0.05);UAP组患者血清IL-6、IL-8、IL-10水平明显高于SAP组和对照组;MMP-9和CRP与IL-6呈正相关(r=0.308,r=0.384,P<0.01)。结论冠心痛与炎性反应密切相关,多种细胞因子参与了动脉粥样硬化斑块的形成和进程,血清炎性细胞因子水平的升高是冠状动脉粥样硬化斑块不稳定的标志。更多还原

【Abstract】 Objective To investigate the effect of inflammation and the cytokines on the genesis and development of coronary heart disease(CHD) by measuring and comparing serum concentrations of IL-6,IL-8,IL-10,CRP,TNF-α and MMP-9 in patients with different clinical kinds of coronary heart disease. Methods Forty-four patients with acute myocardial infarction(AMI) ,44 patients with unstable angina pectoris(UAP),43 patients with stable angina pectoris(SAP),and 35 normal subjects as control were studied. IL-6, IL-8 ,IL-10 ,TNF-α, CRP and MMP-9 in serum were measured and compared among different groups. Results Compared with SAP group and control group, the serum concentrations of IL-6, IL-8, IL-10, CRP, TNF-α and MMP 9 in AMI group were significantly increased (P<0.01). The serum concentrations of IL-10, TNF-α, CRP and MMP-9 in AMI group were significantly higher than those in UAP group, the serum concentrations of IL-6,IL-8 and IL-10 were significantly higher in UAP group than in SAP group and control group. Conclusion CHD is closely associated with inflammatory reaction. IL-6,IL-8,TNF-α,CRP and MMP-9 may take part in the pathophysiological process of acute coronary syndrome(ACS) and may participate in the myocardial injury of AMI. IL-10, as a kind of anti-inflammatory cytokine,inhibits the activity of proinflammatory cytokines and adjusts the genesis and development of acute coronary events.更多还原