趋化因子CCL21、CCL19与急性冠状动脉综合征的相关性研究

Relationship between chemokines CCL19 and CCL21 and acute coronary syndrom

目的:通过研究急性冠脉综合征(ACS)患者血清趋化因子CCL21、CC19的变化,探讨其与冠状动脉病变的相关性。方法:选取102例ACS患者,其中急性ST段抬高的心肌梗死(STEMI)患者33例,非ST段抬高的心肌梗死(NSTEMI)37例,不稳定型心绞痛(UA)患者32例,稳定型心绞痛患者36例,非心源性胸痛并经冠状动脉造影排除冠心病的患者为对照组30例,采用酶联免疫法法测定CCL21、CCL19水平,所有ACS患者进行冠状动脉造影用目测法和Gensini评分对冠脉血管进行损害程度进行评价,来探讨CCL21、CCL19与冠状动脉狭窄范围及程度的关系。结果:ACS组CCL21及CCL19水平明显高于稳定型心绞痛组和对照组,分别为[(149.33±26.24)ng/Lvs.(111.45±24.31)ng/Lvs.(108.38±22.28)ng/L,P<0.01],[(77.45±16.27)ng/Lvs.(54.74±19.44)vs.(57.38±21.28)ng/L,P<0.01]。ACS中STEMI、NSTEMI、UA组内血清CCL21、CCL19水平在组内差异无统计学意义[CCL21:(155.39±21.56)ng/Lvs.(154.38±20.74)ng/Lvs.(157.39±24.33)ng/L,P>0.05;CCL19:(75.34±15.34)ng/Lvs.(77.25±16.21)ng/Lvs.(74.23±24.19)ng/L,P>0.05],冠状动脉狭窄程度及Gensini评分法积分在ACS组内STEMI组、NSTEMI组、UA组比较差异无统计学意义,三组内冠状动脉狭窄程度与外周血CCL21、CCL19水平无明显相关性。结论:外周血CCL21、CCL19水平与急性冠脉综合症血管病变有关,在斑块不稳定中可能扮演着重要的角色。

AIM： To explore the relationship between chemokines CCL19 and CCL21 and the degree of stenosis of coronary artery in patients with acute coronary syndrome （ACS）. METHODS ： One hundred and two patients with acute ACS were included in the study. Included were 33 cases with ST-segment elevation myocardial infarction （STEMI） , 37 cases with non ST-segment elevation myocardial infarction （NSTEMI） , 32 eases with unstable angina, and 36 eases with stable angina （SA）. Recruited as controls were 30 patients with chest pain but no ischemic changes in ECG and no coronall heart disease confirmed by coronaU angiography. The levels of chemokines CCL19 and CCL21 were measured by ELISA and the severity of coronao artery disease was measured bv Gensini scoring sys chemokines CCLI9 and CCL21 in patients with ACS were significantly tern. RESULTS： Serum levels of higher than those in control group [CCL21：（149.33±26.24） ng/Lvs. （111.45 ±22.28） ng/Lvs. （108.38 ±22.28） ng/L, P〈0.01] and [CCLI9：（77.45 ±16.27） ng/L vs. （54.74±19.44） ng/L vs. （57.38±21.28） ng/L, P 〈 0. 01 ]. No significant difference was observed in Gensini scores among the three groups of ACS patients. The levels of ehemokines CCL19 and CCL21 in peripheral blood were not correlated with coronary artery lesions in ACS. CONCLUSION： Levels of CCL19 and CCL21 may reflect the severity of coronary artery disease and play an important role in coronary artery plaque destabilization.