【摘要】 目的 探究巨细胞病毒（CMV）感染对冠心病患者脂代谢和血清凝集素样氧化型低密度脂蛋白受体-1(LOX-1)、基质金属蛋白酶9(MMP-9)、炎症因子的影响及其与冠状动脉病变的关系。方法 2022年6月—2023年12月在邯郸市第一医院就诊的230例冠心病患者，其中168例CMV感染者纳入CMV阳性组，62例未感染CMV者纳入CMV阴性组，比较两组患者血清低密度脂蛋白胆固醇（LDL-C）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、甘油三酯（TG）、LOX-1、MMP-9、白介素6(IL-6)、白介素1β(IL-1β)水平及冠状动脉病变严重程度，并分析CMV感染严重程度与血清LOX-1、MMP-9、IL-6、IL-1β的相关性。结果CMV阳性组患者TC、TG、LDL-C、IL-6、IL-1β、MMP-9、LOX-1水平分别为（5.01±0.65）mmol/L、（1.58±0.49）mmol/L、（3.33±0.64）mmol/L、（12.90±5.72）pg/ml、（10.62±3.50）pg/ml、（341.00±78.54）ng/ml、（207.84±54.30）ng/ml，显著高于CMV阴性组，差异有统计学意义（P<0.05）。CMV阳性组患者冠状动脉多支病变例数构成比为42.86%，高于CMV阴性组的27.42%；冠状动脉重度狭窄例数的构成比为41.67%，高于CMV阴性组的22.58%(P<0.05)。重度狭窄组患者的血清IL-6、IL-1β、MMP-9、LOX-1水平分别为（13.64±7.70）pg/ml、（11.69±4.90）pg/ml、（344.41±55.44）ng/ml、（202.33±24.90） ng/ml，随着冠状动脉病变程度的加重，IL-6、IL-1β、MMP-9、LOX-1水平呈递增趋势，且CMV感染严重程度与IL-6、IL-1β、MMP-9、LOX-1水平呈正相关（P<0.05）。结论 CMV感染与冠状动脉病变的严重程度密切相关。CMV感染可能通过影响冠心病患者的脂代谢及调节血清LOX-1、MMP-9和炎症因子的水平，加剧冠状动脉的损伤。更多还原

【Abstract】 Objective To investigate the impact of cytomegalovirus(CMV) infection on lipid metabolism and serum levels of lectin-like oxidized low-density lipoprotein receptor-1(LOX-1),matrix metalloproteinase 9(MMP-9),and inflammatory factors in patients with coronary heart disease(CHD),as well as its relationship with coronary artery lesions. Methods The study included 230 patients with CHD who were treated at Handan First Hospital from June 2022 to December 2023. Among them,168patients with positive CMV infection were assigned to the CMV-positive group,62 patients with negative CMV infection were assigned to the CMV-negative group. The levels of serum low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),highdensity lipoprotein cholesterol(HDL-C),triglycerides(TG),LOX-1,MMP-9,interleukin-6(IL-6) and interleukin-1β(IL-1β)were compared between the two groups. The severity of coronary artery lesions was also compared,and the correlation between the severity of CMV infection and serum levels of LOX-1,MMP-9,IL-6 and IL-1β was analyzed. Results The levels of TC,TG,LDL-C,IL-6,IL-1β,MMP-9,LOX-1 in the CMV-positive group were(5.01±0.65)mmol/L,(1.58±0.49)mmol/L,(3.33±0.64)mmol/L,(12.90 ±5.72)pg/ml,(10.62 ±3.50)pg/ml,(341.00 ±78.54)ng/ml,(207.84 ±54.30)ng/ml,respectively,which were significantly higher than those in the CMV-negative group(P<0.05). The proportion of patients with multi-vessel coronary artery disease in the CMV-positive group was 42.86%,higher than that in the CMV-negative group(27.42%),the proportion of patients with severe coronary artery stenosis was 41.67%,higher than that in the CMV-negative group(22.58%)(P<0.05). In patients with severe stenosis,the levels of serum IL-6,IL-1β,MMP-9 and LOX-1 were(13.64±7.70)pg/ml,(11.69±4.90)pg/ml,(344.41 ±55.44)ng/ml,(202.33 ±24.90)ng/ml,respectively. With the increasing severity of coronary artery lesions,the levels of IL-6,IL-1β,MMP-9 and LOX-1 showed an increasing trend. The severity of CMV infection was positively correlated with the levels of IL-6,IL-1β,MMP-9 and LOX-1(P<0.05). Conclusion CMV infection was closely related to the severity of coronary artery lesions. CMV infection might exacerbate vascular damage in coronary arteries by affecting lipid metabolism in CHD patients and regulating the levels of serum LOX-1,MMP-9 and inflammatory factors.更多还原