冠心病与肿瘤坏死因子、白细胞介素-6浓度关系的研究

The study of relationship among coronary heart diease,serum levels of TNF and IL-6

采用放射免疫法及酶联免疫吸附法检测35例冠心病患者（其中20例冠状动脉狭窄，15例心肌梗死）及20例健康者血清肿瘤坏死因子（TNF）、白细胞介素-6（IL－6）的浓度及血脂水平。结果显示：①冠心病组较对照组TNF浓度高（P＜0.01），而以心肌梗死组更为明显（P＜0.001）；②冠心病组TNF浓度与胆固醇、低密度脂蛋白-胆固醇、载脂蛋白B100呈正相关，而与高密度脂蛋白-胆固醇、载脂蛋白地呈负相关。③冠状动脉狭窄组与对照组比较IL－6浓度光显著性差异（P＞0．05），但心肌梗死组IL－6浓度显著增高（P＜0．001）。提示：TNF、IL－6与冠心病的发生发展有关，IL－6参与了急性心肌梗死的缺血损伤；内皮细胞受损，TNF、IL－6作用，脂质代谢的异常是冠心病发生的重要环节。

The serum levels of tumor necrosis factor (TNF), interleukin-6 (IL-6) from' 35 coronary heart disease (CHD) patients (15 of them were AMI and 20 of them were only narrow coronary artery by coronary angiography) and 20 of healthy people were studied by radio-im-munoassay and enzyme-linked immunosorbent assay. The plasma levels of lipoproteins were also measured. The results showed: (1) The serum levels of tumor necrosis factor of the CHD group (especial of the AMI group) were much higher than those of the control group (P <0.001). (2)In the CHD group,the serum levels of TNF had apparent positive correlation with those of cholesterol,low-density lipoprotein-cholesterol and apoB100 and had negative correlation with those of high-density lipoprotein-cholesterol (HDL-C) and aPoA1. (3) There was no obvious difference of the serum levels of IL-6 between the narrow coronary artery group and the control group (P > 0.05). But of the AMI group was higher than the other groups (P <0.001). These findings indicate that the high levels of TNF may be the risk factors of CHD. The effect of the cytokines and the abnormal metabolism of cholesterol play an important role in the pathogenesis of CHD.