血清趋化蛋白水平与冠脉病变程度和冠心病危险因素的关系

The clinical relations among the serum level of monocyte chemoattractant protein-1(MCP-1) with the severity of coronary atherosclerosis and its relationships with high risks

目的检测冠心病患者血清趋化蛋白(MCP-1)水平并分析其与冠脉病变程度和冠心病危险因素的关系。方法选择经冠脉造影证实的冠心病非高血压患者42例,健康人36名。根据病例冠脉造影结果,对患者冠脉病变程度进行记分,采用双抗体夹心ELISA法测定冠心病患者和健康人血清MCP-1、血脂和C反应蛋白的水平,同时按常规方法测定血压。分析冠心病患者血清MCP-1水平冠脉病变程度和冠心病危险因素的关系,比较冠心病患者与健康人血清MCP-1水平和其他炎性指标的差异。结果与健康人比较,冠心病患者血清MCP-1水平均明显增高[(408±121)μg/L和(739±243)μg/L,P<0.01],而C反应蛋白虽较健康人略有增高,但差异无统计学意义。同时,相关分析结果表明,冠心病患者血清MCP-1水平与冠脉病变程度记分呈显著正相关(相关系数r=0.58,P<0.01)。相关分析还显示,冠心病血清可溶性黏附分子MCP-1水平与血浆总胆固醇(相关系数r=0.46,P<0.05)和低密度脂蛋白(相关系数r=0.67,P<0.01)均呈显著正相关。结论冠心病患者血清MCP-1水平明显增高,它们的水平与冠脉病变的严重程度相关,有可能作为评价冠心病发展的血清学指标。

Objective To explore the clinical relations among the serum level of monocyte chemoattractant protein-1（ MCP-1 ） with the severity of coronary atherosclerosis and its relationships with high risks. Methods Forty two normotensive patients with coronary heart disease （CHD） undergoing diagnostic coronary angiography were randomly selected. These patients were compared against a control population with no known coronary heart disease, The serum level of MCP-1 were measured by enzyme-linked immunosorbent assay （ELISA） and LDL, TC, C-reactive protein （CRP） was obtained by clinical routine methods. Relationships between levels of MCP-1 and risk factors for atherosclerosis were evaluated and the differences among the levels of MCP-1 for the groups were also assessed. Results （ 1 ）The level of MCP-1 in patients with coronary heart disease was significantly higher than those of health individuals [（408±121）μg/L vs （739±243）μg/L, P〈0.01 ]. CRP of patients was also higher in patients with coronary heart disease, but the differences had no statistic significance （P〉0.05）. A significantly correlation between the severity of the coronary artery lesions and the serum level of MCP-1 （r=0.58,P〈0.01） was found. It also showed serum levels of MCP-1 relate significantly to TC （r=0.46,P〈0.05） and LDL （r=0.67,P〈 0.01 ）. Conclusion The serum levd of MCP-1 was elevated in patients with CHD, They relate to the severity of atherosclerosis and may serve as an available index for the severity of CHD.