【作者】 邓学军；

【导师】 覃数；

【作者基本信息】 重庆医科大学 ， 心血管内科， 2005， 硕士

【摘要】 目的:探讨冠心病患者血清 IL-10,IL-6,PAPP-A 水平变化及NF-κB 活化, 旨在探索 IL-10,IL-6,PAPP-A 是否有可能作为预测 ACS的血清指标。 方法:对 45 例 ACS 患者(15 例 AMI,30 例 UAP),20 例 SAP患者,20 例对照者,采用 ELISA 法检测外周血清 IL-10,IL-6,PAPP-A水平,免疫比浊法测定 HsCRP。采用细胞免疫组化法,计算 PBMC NF-κBp65 细胞核表达阳性率。采用冠状动脉造影,计算冠脉病变支数,采用累计 Gensini 积分法评测冠状动脉病变程度。 结果: (1) ACS 患者 PBMC NF-κB 明显活化,ACS 组 PBMC 细胞核 NF-кBp65 表达率明显高于 SAP 组及对照组(ACS:0.323±0.125,SAP:0.134±0.076,Control:0.112±0.089,均 P <0.05)。(2)ACS 组外周血清IL-6水平较SAP组,对照组升高(ACS: 25.81±16.79 ng/L,SAP:10.79±6.07 ng/L,Control:7.65±3.71 ng/L,均 P <0.05)。 (3) CHD 各组外周血清 IL-10 水平高于对照组(ACS:18.23±11.42 ng/L,SAP:16.20±9.98 ng/L,Control:9.40±8.09 ng/L,均 P <0.05), 而 ACS 组与SAP 组比较无差异(P >0.05)。(4) ACS 组外周血清 IL-6/IL-10 比值高于SAP 组及对照组(ACS: 1.64±1.01,SAP: 1.06±1.18,Control: 0.92±0.51,均 P <0.05)。(5) ACS 组外周血清 PAPP-A 水平明显高于 SAP 组及对照组 (ACS: 36.217±12.638 mIU/L,SAP:15.313±7.646 mIU/L,Control:13.152±3.374 mIU/L,均 P <0.05);血清 PAPP-A 水平与冠脉病变支数及冠脉累计 Gensini 积分无相关。(6) ACS 组外周血清 HsCRP 水平明显更多还原

【Abstract】 Objective: To evaluate the difference of the serum IL-10, IL-6 , PAPP-A levels and Nuclear factor-κappa B activation in patients with coronary heart disease and to explore the potential predicting value for the ACS. Meathod: The study groups included 45 cases of ACS (AMI 15cases, UAP 30cases), 20 cases SAP and 20 cases of without CHD as control group. Serum level of IL-10, IL-6, PAPP-A was measured by means of ELISA, HsCRP measued by immunityturbidimetry, while NF-κB Activation measured by cell immunohistochemical method In PBMC. Acording to the result of coronarary teriongraphy, vessel Lesions branchs and accumulated points of Gensini about vessel Lesions was measured. Result:(1) NF-κB was more activated in ACS,the level of NF-κB activation was significantly higher in patients with ACS than in those of SAP and Control group,( ACS:0.323± 0.125 , SAP : 0.134 ±0.076, Control :0.112±0.089,respectively P <0.05);(2) The level of IL-6 was significantly higher in patients with ACS than in those of SAP and Control group,(ACS:25.81±16.79 ng/L,SAP:10.79±6.07 ng/L,Control:7.65±3.71 ng/L,respectively P <0.05);(3) The level of IL-10 was significantly higher in patients with each group of CHD than in those of Control group (ACS:18.23±11.42 ng/L,SAP:16.20±9.98 ng/L,Control:9.40±8.09 ng/L,respectively P <0.05),but no difference between ACS and SAP was found (P>0.05);(4) The ratio IL-6/IL-10 was significantly higher in patients with ACS than in those of SAP and Control(ACS: 1.64±1.01,SAP: 1.06±1.18, Control: 0.92±0.51,P<0.05); (5) The level of PAPP-A was significantly higher in patients with ACS than in those of SAP and Control(ACS:36.217±12.638 mIU/L,SAP:15.313±7.64 mIU/L,Control:13.152±3.374 mIU/L, P<0.05),The level of PAPP-A was not correlated with vessel Lesions branchs, not correlated with accumulated points of Gensini about vessel Lesions;(6) The level of HsCRP was significantly higher in patients with ACS than in those of SAP and Control(ACS:3.234±2.573 mg/L,SAP:1.035±0.509 mg/L,Control :0.604±0.720 mg/L,P<0.05),The level HsCRP was significantly correlated with vessel Lesions branchs and accumulated points of Gensini about vessel Lesions;(7) In CHD patients,NF-κB activation was positively correlated with the level of serum IL-6(r=0.51,P<0.05),the level of serum PAPP-A was positively correlated with that of HsCRP(r=0.436,P<0.05). Conclusion:(1) NF-κB was actived in ACS patients,The level of serum IL-6 was significantly higher in patients with ACS,IL-6 has possiblely predicting diagnostic value for ACS;(2) The ratio IL-6/IL-10 was significantly higher in ACS,IL-6/IL-10 maybe have predicting diagnostic value for ACS;(3) The level of serum PAPP-A was significantly higher in patients with ACS,PAPP-A is possiblely a predicting diagnostic marker for ACS,but PAPP-A is not a sensitive predicting marker for severity of coronary vessel Lesions;(4) HsCRP is possiblely a predicting diagnostic marker for ACS and severity of coronary vessel Lesions.更多还原