急性冠脉综合征患者外周血MCP-1和IL-18水平变化的临床意义

Changes and implications of monocyte chemoattractant protein-1 and interleukin-18 in peripheral blood of patients with acute cronary syndrome

目的探讨急性冠脉综合征患者外周血单核/巨噬细胞趋化蛋白1(MCP-1)和白细胞介素18(IL-18)水平变化的意义及其相关性。方法酶联免疫吸附法测定30例急性冠脉综合征患者(急性冠脉综合征组),30例稳定型心绞痛患者(稳定型心绞痛组)及29例胸痛、胸闷等症状予以冠脉造影正常的患者(对照组)外周血MCP-1和IL-18水平的变化,并分析冠状动脉的病变情况。结果①急性冠脉综合征组MCP-1水平[(151.84±29.66)pg/ml]显著高于稳定型心绞痛组[(128.49±16.97)pg/ml,P<0.001]和对照组[(112.11±10.36)pg/ml,P<0.01],并且稳定型心绞痛组和对照组比较有统计学意义(0.001<P<0.01)。②急性冠脉综合征组IL-18水平(109.31±29.35)pg/ml显著高于稳定型心绞痛组[(72.47±21.02)pg/ml,P<0.01]和对照组[(70.48±22.34)pg/ml,P<0.001]。③急性冠脉综合征组和稳定型心绞痛组冠状动脉狭窄程度积分与外周血MCP-1和IL-18水平均无显著性相关(P>0.05)。④急性冠脉综合征组外周血MCP-1和IL-18呈明显正相关(r=0.519,P<0.01)。结论外周血MCP-1和IL-18水平可以判断冠心病的严重程度,能预测急性冠脉综合征发生的危险性,但与冠状动脉的病变程度无明显关系,MCP-1和IL-18的正相关提示因子间相互作用可能共同促进冠脉综合征的发生和发展。

Objective To explore the correlation and its significance of Monocyte Chemoattractant Protein-1(MCP-1) and Interleukin-18(IL-18) in the peripheral blood of patients with Acute Cronary Syndrome(ACS). Methods The peripheral blood concentrations of Monocyte Chemoattractant Protein-1(MCP-1) and Interleukin-18(IL-18) were measured in thirty patients with ACS(ACS group ) ,thirty patients with Stable Angina pectoris (SAP group) and twenty-nine patients with Control subjects (Control group) by enzyme-linked immunobsorbent assay (ELISA).The aspects of coronary artery lesions were analyzed. Results ①Monocyte Chemoattractant Protein-1(MCP-1) level was significantly higher in patients with Acute Cronary Syndrome(ACS)(151.84±29.66)pg/ml than in those of Stable Angina pectoris (SAP) [(128.49±16.97)pg / ml,P<0.001] and control group[(112.11±10.36)pg / ml,P<0.001], and Monocyte Chemoattractant Protein-1(MCP-1) level of Stable Angina pectoris (SAP) was evidently higher than this of control group(0.001<P<0.01) ②IL-18 level was significantly higher in patients with Acute Cronary Syndrome(ACS) (109.31±29.35)pg / ml than in those of Stable Angina pectoris (SAP) [(72.47±21.02)pg / ml,P<0.001= and control group[(70.48±22.34)pg / ml,P<0.001= ③The levels of MCP-1or IL-18 in peripheral blood was not correlated with culprit coronary artery lesions in ACS and SAP groups( p>0.05) ④Monocyte Chemoattractant Protein-1(MCP-1) level was positively correlated with Interleukin-18(IL-18) level in Acute Cronary Syndrome(ACS) (r=0.519,P<0.01=.Conclusion The levels of Monocyte Chemoattractant Protein-1(MCP-1) and Interleukin-18(IL-18)in peripheral blood can evaluate the severity of Coronary Heart Disease(CHD)and can be two useful makers reflecting the unstable stable of the disease,but the levels of MCP-1or IL-18 in peripheral blood have no correlation with the degree of coronary artery lesions in ACS and SAP groups . And there are intrinsic correlation between the levels of MCP-1or IL-18 in peripheral blood, which implicates that the interaction of inflammatory factors may facilitate the development of Acute Cronary Syndrome(ACS).