冠心病患者血清细胞因子和超敏C-反应蛋白水平测定的临床意义

目的 探讨冠心病患者血清中细胞因子和超敏C-反应蛋白(hs-CRP)水平的临床意义.方法 利用放射免疫分析和超敏酶免疫分析法测定124例冠心病患者其中稳定型心绞痛(SA)41例,不稳定型心绞痛(USA)38例,急性心肌梗死(AMI)45例]血清中自细胞介素1 β(IL-1 β)、白细胞介素6(IL-6)、白细胞介素8(IL-8)、肿瘤坏死因子α(TNF-α)和hs-CRP水平,并与54名正常对照者进行对比研究.结果 124例冠心病患者血清IL-1β、IL-6、IL-8和TNF-α水平较54名正常对照者明显升高(tIL-1β=3.145,tIL-6=3.627,tIL-8=3.054,tTNF-α=3.301,P均＜0.01).其中,41例SA患者血清IL-1β、IL-6、IL-8和TNF-α水平与54名正常对照者比较差异无统计学意义(tIL-1β=1.431,tIL-6=1.587,tIL-8=1.745,tTNF-α=1.461,P均＞0.05);38例USA和45例AMI患者血清中IL-1β、IL-6、IL-8和TNF-α水平较54名正常对照者明显升高(USA:tIL-1β=2871,tIL-6=2.748,tIL-8=2.687,tTNF-α=3.145,P均＜0.01;AMI:tIL-1β=2.776,tIL-6=2.874,tIL-8=2.689,tINF-α=3.212,P均＜0.01);SA、USA和AMI3组患者血清hs-CRP水平较正常对照者升高(tSA=2.617,P＜0.05;tUSA=3.018,P＜0.01;tAMT=3.189,P＜0.01).冠心病患者血清中IL-1β、IL-6、IL-8、TNF-α和hs-CRP水平随疾病的严重程度而逐渐升高,以AMI患者为最高.结论 血清IL-1β、IL-6、IL-8、TNF-α和hs-CRP水平的测定是诊断SA、USA和AMI疾病的重要指标,并可作为诊断心血管事件发生的参考.

Clinical application of changes of serum cytokines and hypersensitive C-reactive protein in patients with coronary heart disease

Objective To study clinical application of the changes of serum cytokines and hypersensitive C-reactive protein (hs-CRP) in patients with coronary heart disease. Methods The levels of interleukin-1β(IL-1β), interleukin-6(IL-6), interleukin-8(IL-8), hs-CRP(with high-sensitive enzyme immunoassay)and tumor necrosis factor α(TNF-α)(with radioimmunoassay) in blood serum were determined in 124 patients with coronary heart disease( including 41 patients with stable angina pectoris(SA), 38 patients with unstable angina (USA) and 45 patients with acute myocardial infarction (AMI)) and 54 normal controls, and then comparatively analysed all the data. Results The levels of IL-1β, IL-6, IL-8 and TNF-α in 124 patients with coronary heart disease were significantly higher than those in 54 normal controls (tIL-1β=3.145, tIL-6=3.627, tIL-8=3.054, tTNF-α=3.301, P＜0.01). The levels of IL-1β, IL-6, IL-8 and TNF-α in 41 patients with SA were no significantly than those in 54 normal controls (tIL-1β= 1.431, tIL-6= 1.587, tIL-8= 1.745, tTNF-α= 1.461, P＞0.05). The levels of IL-1β, IL-6, IL-8 and TNF-α in 38 patients with USA and in 45 patients with AMI were significantly higher than those of in 54 normal controls(USA: tIL-1β=2.871, tIL-6=2.748, tIL-8=2.687, tTNF-α=3.145, P＜0.01; AMI: tIL-1β=2.776,tIL-6=2.874, tIL-8=2.689, tTNFα=3.212, P＜0.01). The level of hs-CRP in SA, USA and AMI groups were higher than thoes in normal controls (tSA=2.617, P＜0.05; tUSA=3.018, P＜0.01; tAMI=3.189, P＜0.01). The levels of IL-1β, IL-6,IL-8, TNF-α and hs-CRP had increasing tendency follow up the severity degree of patients with SA or USA or AMI and the levels of IL-1β, IL-6, IL-8, TNF-α and hs-CRP in patients with AMI were highest in 124 patients with coronary heart disease. Conclusion In the diagnosis of the patients with SA, USA and AMI, the determination of the levels of IL-1β, IL-6, IL-8, TNF-α and hs-CRP in blood serum were important index, and they were references for cardiovascular happened.