巨细胞病毒感染与冠心病患者的白细胞介素-10水平升高相关

Cytomegalovirus infection is associated with elevated interleukin-10 in coronary artery disease

目的探讨CMV感染对冠心病患者血清IL-10的影响。方法冠心病患者106例和冠状动脉造影证实的冠状动脉光滑者82例作为对照,ELISA法检测特异性CMV IgG,双单抗夹心法定量测定血清IL-10水平。据研究个体的IL-10中位数水平(6.84 pg/ml)进行高、低IL-10分组,行单因素和多因素Logistic回归分析高水平IL-10的影响因素。结果冠心病组与对照组相比,CMVIgG阳性率差异不显著(38.9%vs.37.6%,P>0.05);冠心病组IL-10水平显著高于对照组,7.3(3.0-12.5)pg/ml vs.5.9(3.2-10.4)pg/ml(P=0.043)。高IL-10患者的CMV IgG阳性率显著高于低IL-10患者(46.8%vs.30.4%,P<0.001);在冠心病组,高IL-10组中的CMVIgG阳性率显著高于低IL-10组(48.1%vs.28.6%,P<0.001),而在冠状动脉光滑患者的高、低IL-10组中,未见CMV IgG阳性率的显著差异(40.4%vs.35.6%,P=0.588);IL-10升高相关因素的多元Logistic回归分析显示,在冠心病组,CMV IgG阳性与高IL-10独立相关,调整的OR值为2.3(1.6～3.4,P<0.001),而在对照组则为1.1(0.5～2.5,P=0.83)。调整变量包括年龄、性别、吸烟、高血压、血脂紊乱、糖尿病及较少体力活动。结论CMV感染与冠心病患者血清IL-10水平升高独立相关,在冠心病患者,CMV感染的免疫应答可能是一个影响细胞因子网络的复杂反应。

Objective Investigated the impact of CMV infection on serum IL-IO levels in patients with CAD. Methods Specific CMV IgG and serum levels of IL-IO were measured with ELISA in patients with CAD （n = 106） and smooth coronary artery controls documented angiographically （n =82）. Subjects were dichotomized according to calculated median level of IL-10 （6.84 pg/ml） in different groups or sub- groups. Univariate and multivariate analyses were performed to analyse the contributors of high IL-10. Resuits The seropositivity of CMV IgG was not significantly different between CAD and control groups （38.9% vs. 37.6%, P 〉0.05）. IL-10 level in the patients with CAD was higher than that in the controls [ 7.3 （3.0 -12.5） pg/ml vs. 5.9 （3.2 - 10.4） pg/ml, P = 0. 043 ]. The seropositivity of CMV IgG was more frequently found in the high IL-10 group than the low IL-10 group （46.8% vs. 30.4%, P 〈0. 001 ）. The prevalence of CMV infection was significantly higher in the high IL-IO group than the low IL-10 group among the patients with CAD （48.1% vs. 28.6 % ,P 〈0.001 ）, but not among the controls （40.4% vs. 35.6% ,P = O. 588 ）. On multiple logistic regression analysis, the adjusted odds ratio of high IL-10 associated with CMV infection was 2.3 （ 1.6 - 3.4, P 〈 0. 001 ） in the patients with CAD, and 1.1 （0.5 - 2.5, P = 0. 83 ） in the controls. Conclusion We found a significant association of CMV infection with elevated IL- l0 in patients with CAD, but not in those with smooth coronary artery. Therefore, we propose that changes in the immune response to CMV are a compounding factor in CAD