CAJ | 학술논문

目的：通过检测冠状动脉病变患者的血清超敏C反应蛋白(High-sensitivity C-reactive protein， Hs-CRP)、肿瘤坏死因子α(Tumor necrosis factorα，TNF-α)和白细胞介素-6含量(Interleukin-6，IL-6)，探讨三者与冠状动脉粥样硬化程度的关系，从而评价三者对冠心病的临床诊断价值。方法经冠状动脉造影证实冠状动脉没有明显狭窄者入选对照组，共37例；有一支血管狭窄者入选单支病变组，共36例；有两支血管狭窄者入选双支病变组，共30例；有大于两支血管狭窄者入选多支病变组，共29例。对四组分别进行血清超敏C反应蛋白、肿瘤坏死因子α和白细胞介素-6检测。结果对照组、单支病变组、双支病变组、多支病变组的Hs-CRP、TNF-α和IL-6浓度水平依次呈递增趋势，四组之间差异有统计学意义(P<0.05)。经logistic回归分析显示，血Hs-CRP、TNF-α和IL-6均为影响冠状动脉病变的因素，其中超敏C反应蛋白对冠状动脉病变的影响的优势比为6.847，强于TNF-α和IL-6的5.347和1.102。结论炎性因子是冠心病的强预测因子，其浓度随着冠状动脉病变程度的增加而升高。炎性因子可通过相互诱导、相互协同共同参与冠心病的发生、发展过程，可作为冠心病的检测和早期诊断病情的指标。
목적：통과검측관상동맥병변환자적혈청초민C반응단백(High-sensitivity C-reactive protein， Hs-CRP)、종류배사인자α(Tumor necrosis factorα，TNF-α)화백세포개소-6함량(Interleukin-6，IL-6)，탐토삼자여관상동맥죽양경화정도적관계，종이평개삼자대관심병적림상진단개치。방법경관상동맥조영증실관상동맥몰유명현협착자입선대조조，공37례；유일지혈관협착자입선단지병변조，공36례；유량지혈관협착자입선쌍지병변조，공30례；유대우량지혈관협착자입선다지병변조，공29례。대사조분별진행혈청초민C반응단백、종류배사인자α화백세포개소-6검측。결과대조조、단지병변조、쌍지병변조、다지병변조적Hs-CRP、TNF-α화IL-6농도수평의차정체증추세，사조지간차이유통계학의의(P<0.05)。경logistic회귀분석현시，혈Hs-CRP、TNF-α화IL-6균위영향관상동맥병변적인소，기중초민C반응단백대관상동맥병변적영향적우세비위6.847，강우TNF-α화IL-6적5.347화1.102。결론염성인자시관심병적강예측인자，기농도수착관상동맥병변정도적증가이승고。염성인자가통과상호유도、상호협동공동삼여관심병적발생、발전과정，가작위관심병적검측화조기진단병정적지표。
Objective To explore the correlation between high-sensitivity C-reactive protein (Hs-CRP), tu-mor necrosis factorα(TNF-α) and interleukin-6 (IL-6) and the severity of coronary artery lesion, and to evaluate the clinical value of these three serum inflammatory cytokines in diagnosing coronary heart disease. Methods Thirty-sev-en patients without coronary artery stenosis proved by CAG were enrolled as the control group. Thirty-six patients with single branch hemadostenosis were enrolled as the single branch lesion group. Thirty patients with double branch hemadostenosis were enrolled as the double branch lesion group. Twenty-nine patients with multi-branch hemadoste-nosis were enrolled as the multi-branch lesion group. The levels of serum Hs-CRP, TNF-αand IL-6 in four groups were detected and compared. Results The levels of serum Hs-CRP, TNF-αand IL-6 in patients increased progressive-ly from control group to multi-branch group, which were of statistical significance. Serum Hs-CRP, TNF-α,IL-6 were all risk factors to coronary artery lesion by Logistic regression analysis and the influence of Hs-CRP to coronary artery lesion was stronger than that of TNF-αand IL-6 (odds ratio=6.847 vs 5.347, 1.102 ). Conclusion Inflammatory cyto-kines could predict coronary heart disease and their levels increases with the aggravation of coronary artery lesion. They play an important role in the pathogenesis of coronary heart disease through mutual induction and synergistic actions, which has important value in the judgment of the progress, evaluation and prognosis of coronary heart disease.