实用心脑肺血管病杂志
實用心腦肺血管病雜誌
실용심뇌폐혈관병잡지
PRACTICAL JOURNAL OF CARDIAC CEREBRAL PNEUMAL AND VASCULAR DISEASE
2015年
3期
9-12
,共4页
李冰%吴泽彬%黄桂锋%陈泽海
李冰%吳澤彬%黃桂鋒%陳澤海
리빙%오택빈%황계봉%진택해
急性冠脉综合征%白介素6%白介素8%白介素10%白介素18
急性冠脈綜閤徵%白介素6%白介素8%白介素10%白介素18
급성관맥종합정%백개소6%백개소8%백개소10%백개소18
Acute coronary syndrome%Interleukin-6%Interleukin-8%Interleukin-10%Interleukin-18
目的：观察急性冠脉综合征（ACS）患者血清白介素（IL）6、8、10、18水平变化，探讨其与冠状动脉病变程度的关系。方法选取2012年2月—2014年9月因非特异性胸部不适而在汕头市潮阳区大峰医院接受冠状动脉造影检查患者248例，根据造影结果分为ACS组159例、稳定性心绞痛组（ SA组）47例、对照组42例，其中ACS组中急性心肌梗死（ AMI）患者65例（ AMI组），不稳定性心绞痛（ UA）患者94例（ UA组）。采用酶联免疫吸附试验（ ELISA）检测各组受试者血清IL-6、IL-8、IL-10、IL-18水平，并分析其与ACS患者冠状病变程度的相关性。结果 AMI、UA、SA组患者血清IL-6、IL-8、IL-18水平高于对照组，AMI、UA组高于SA组，AMI组高于UA组（P<0.05）；AMI、UA组患者血清IL-10水平低于对照组和SA组，UA组低于AMI组（P<0.05）。159例ACS患者中单支病变29例、双支病变56例、三支病变51例、多支病变23例，不同病变支数患者血清IL-6、IL-10、IL-18水平比较，差异无统计学意义（ P>0.05）；单支病变、双支病变、三支病变患者血清IL-8水平低于多支病变患者，单支病变患者低于三支病变患者（ P<0.05）。159例ACS患者中，修正的Gensini积分等级G1级24例、G2级71例、G3级36例、G4级28例，G4级患者血清IL-6水平高于G1级患者（P<0.05）；G2、G3、G4级患者血清IL-8、IL-18水平高于G1级患者，G3、G4级患者高于G2级患者，G4级患者高于G3级患者（P<0.05）；G2、G3、G4级患者血清IL-10水平低于G1级患者，G3、G4级患者低于G2级患者，G4级患者低于G3级患者（P<0.05）。Spearman相关分析结果显示，血清 IL -18水平与冠状动脉病变支数呈正相关（r =0.196，P <0.05），而血清 IL -6（r =0.013）、IL-8（r=0.019）、IL-10（r=-0.014）水平与冠状动脉病变支数均无直线相关性（P>0.05）；线性相关分析结果显示，血清IL-18水平与修正的Gensini积分呈正相关（r=0.261，P<0.05），而血清IL-6（r=0.028）、IL-8（r=0.039）、IL-10（r=-0.022）水平与修正的Gensini积分均无直线相关性（P>0.05）。结论 ACS患者存在促炎/抗炎因子失衡，监测血清IL-18水平有助于判断ACS患者冠状动脉病变程度，而IL-6、IL-8、IL-10特异性较差。
目的：觀察急性冠脈綜閤徵（ACS）患者血清白介素（IL）6、8、10、18水平變化，探討其與冠狀動脈病變程度的關繫。方法選取2012年2月—2014年9月因非特異性胸部不適而在汕頭市潮暘區大峰醫院接受冠狀動脈造影檢查患者248例，根據造影結果分為ACS組159例、穩定性心絞痛組（ SA組）47例、對照組42例，其中ACS組中急性心肌梗死（ AMI）患者65例（ AMI組），不穩定性心絞痛（ UA）患者94例（ UA組）。採用酶聯免疫吸附試驗（ ELISA）檢測各組受試者血清IL-6、IL-8、IL-10、IL-18水平，併分析其與ACS患者冠狀病變程度的相關性。結果 AMI、UA、SA組患者血清IL-6、IL-8、IL-18水平高于對照組，AMI、UA組高于SA組，AMI組高于UA組（P<0.05）；AMI、UA組患者血清IL-10水平低于對照組和SA組，UA組低于AMI組（P<0.05）。159例ACS患者中單支病變29例、雙支病變56例、三支病變51例、多支病變23例，不同病變支數患者血清IL-6、IL-10、IL-18水平比較，差異無統計學意義（ P>0.05）；單支病變、雙支病變、三支病變患者血清IL-8水平低于多支病變患者，單支病變患者低于三支病變患者（ P<0.05）。159例ACS患者中，脩正的Gensini積分等級G1級24例、G2級71例、G3級36例、G4級28例，G4級患者血清IL-6水平高于G1級患者（P<0.05）；G2、G3、G4級患者血清IL-8、IL-18水平高于G1級患者，G3、G4級患者高于G2級患者，G4級患者高于G3級患者（P<0.05）；G2、G3、G4級患者血清IL-10水平低于G1級患者，G3、G4級患者低于G2級患者，G4級患者低于G3級患者（P<0.05）。Spearman相關分析結果顯示，血清 IL -18水平與冠狀動脈病變支數呈正相關（r =0.196，P <0.05），而血清 IL -6（r =0.013）、IL-8（r=0.019）、IL-10（r=-0.014）水平與冠狀動脈病變支數均無直線相關性（P>0.05）；線性相關分析結果顯示，血清IL-18水平與脩正的Gensini積分呈正相關（r=0.261，P<0.05），而血清IL-6（r=0.028）、IL-8（r=0.039）、IL-10（r=-0.022）水平與脩正的Gensini積分均無直線相關性（P>0.05）。結論 ACS患者存在促炎/抗炎因子失衡，鑑測血清IL-18水平有助于判斷ACS患者冠狀動脈病變程度，而IL-6、IL-8、IL-10特異性較差。
목적：관찰급성관맥종합정（ACS）환자혈청백개소（IL）6、8、10、18수평변화，탐토기여관상동맥병변정도적관계。방법선취2012년2월—2014년9월인비특이성흉부불괄이재산두시조양구대봉의원접수관상동맥조영검사환자248례，근거조영결과분위ACS조159례、은정성심교통조（ SA조）47례、대조조42례，기중ACS조중급성심기경사（ AMI）환자65례（ AMI조），불은정성심교통（ UA）환자94례（ UA조）。채용매련면역흡부시험（ ELISA）검측각조수시자혈청IL-6、IL-8、IL-10、IL-18수평，병분석기여ACS환자관상병변정도적상관성。결과 AMI、UA、SA조환자혈청IL-6、IL-8、IL-18수평고우대조조，AMI、UA조고우SA조，AMI조고우UA조（P<0.05）；AMI、UA조환자혈청IL-10수평저우대조조화SA조，UA조저우AMI조（P<0.05）。159례ACS환자중단지병변29례、쌍지병변56례、삼지병변51례、다지병변23례，불동병변지수환자혈청IL-6、IL-10、IL-18수평비교，차이무통계학의의（ P>0.05）；단지병변、쌍지병변、삼지병변환자혈청IL-8수평저우다지병변환자，단지병변환자저우삼지병변환자（ P<0.05）。159례ACS환자중，수정적Gensini적분등급G1급24례、G2급71례、G3급36례、G4급28례，G4급환자혈청IL-6수평고우G1급환자（P<0.05）；G2、G3、G4급환자혈청IL-8、IL-18수평고우G1급환자，G3、G4급환자고우G2급환자，G4급환자고우G3급환자（P<0.05）；G2、G3、G4급환자혈청IL-10수평저우G1급환자，G3、G4급환자저우G2급환자，G4급환자저우G3급환자（P<0.05）。Spearman상관분석결과현시，혈청 IL -18수평여관상동맥병변지수정정상관（r =0.196，P <0.05），이혈청 IL -6（r =0.013）、IL-8（r=0.019）、IL-10（r=-0.014）수평여관상동맥병변지수균무직선상관성（P>0.05）；선성상관분석결과현시，혈청IL-18수평여수정적Gensini적분정정상관（r=0.261，P<0.05），이혈청IL-6（r=0.028）、IL-8（r=0.039）、IL-10（r=-0.022）수평여수정적Gensini적분균무직선상관성（P>0.05）。결론 ACS환자존재촉염/항염인자실형，감측혈청IL-18수평유조우판단ACS환자관상동맥병변정도，이IL-6、IL-8、IL-10특이성교차。
Objective To observe the changes of serum levels of IL-6,IL-8,IL-10,IL-18 of ACS patients, to investigate their correlations with severity of coronary artery lesions. Methods A total of 248 patients with non-specific cheat discomfort undergoing coronary arteriography were selected in the Dafeng Hospital of Chaoyang District from February 2012 to September 2014,and they were divided into control group(with normal coronary arteriography results,n =42),SA group (with stable angina pectoris,n=47),UA group(with unstable angina pectoris,n=94),AMI group(with acute myocardial infarctio,n=65)according to coronary arteriography results. ELISA was used to detect the serum levels of IL-6,IL-8,IL-10,IL-18,and their correlations with severity of coronary artery lesions of ACS patients were analyzed. Results Serum levels of IL-6,IL-8,IL-18 of groups AMI,UA,SA were higher than those of control group(P<0. 05),respectively;above index of groups AMI and UA were higher than those of SA group(P<0. 05),respectively;above index of AMI group were higher than those of UA group(P<0. 05). Serum IL-10 level of groups AMI and UA was lower than that of control group and SA group(P <0. 05),respectively;serum IL -10 level of UA group was lower than that of AMI group(P <0. 05). According to the numbers of stenosed coronary vessel,the 159 ACS patients were divided into groups A( with single vessel lesion,n=29),B(with double vessel lesions,n=56),C(with triple vessel lesions,n=51),D(with multiple vessel lesions,n=23),and no statistically significant differences of serum levels of IL-6,IL-10,IL-18 was found among the four groups(P<0. 05);while serum IL-8 level of groups A,B and C was lower than that of D group(P<0. 05),respectively;serum IL-8 level of A group was lower than that of C group(P<0. 05). According to modified Gensini′s score,the 159 ACS patients were divided into groups G1(n=24),G2(n=71),G3(n=36),G4(n=28). Serum IL-6 level of G4 group was higher than that of G1 group(P<0. 05). Serum levels of IL-8 and IL-18 of groups G2,G3 and G4 were higher those that of G1 group(P<0. 05),respectively;serum levels of IL-8 and IL-18 of groups G3 and G4 were higher than those of G2 group(P<0. 05),respectively;serum levels of IL -8 and IL -18 of G4 group were higher than those of G3 group(P <0. 05). Serum IL-10 level of groups G2,G3 and G4 was lower than that of G1 group(P<0. 05),respectively;serum IL-10 level of groups G3 and G4 was lower than that of G2 group(P<0. 05),respectively;serum IL-10 level of G4 group was lower than that of G3 group ( P <0. 05 ). Spearman correlation analysis showed that, serum IL - 18 level was positively correlated with the numbers of stenosed coronary vessel(r=0. 196,P<0. 05),while no rectilinear correlatios was found with serum levels of IL-6 ( r =0. 013 ), IL -8 ( r =0. 019 ) or IL -10 ( r = -0. 014 ) ( P >0. 05 );rectilinear correlation analysis showed that serum IL-18 level was positively correlated with modified Gensini′s score(r=0. 261,P<0. 05),while no rectilinear correlatios was found with serum levels of IL-6(r=0. 028),IL-8(r=0. 039)or IL-10(r= -0. 022)(P>0. 05). Conclusion Pro-/anti-inflammatory cytokines of ACS patients were out-of-balance,monitoring serum IL-18 level is helpful to judging the severity of coronary artery lesions,while serum levels of IL-6,IL-8,IL-10 are with poor specificity.
