冠心病患者血浆组织因子、组织因子途径抑制物、白介素18、白介素10水平的变化及其关系

Changes in plasma tissue factor,tissue factor pathway inhibitor,interleukin-18 and interleukin-10 concentrations in patients with coronary heart disease and their relationships

目的观察冠心病患者血浆组织因子(TF)、组织因子途径抑制物(TFPI)、白介素18(IL-18)、白介素10(IL-10)的变化,探讨其在冠心病(CHD)中的意义及其相互关系。方法 121例患者分为对照组(33例)与CHD组(96例),CHD组又分为急性心肌梗死(AMI)(33例),不稳定性心绞痛(UAP)(33例)和稳定性心绞痛(SAP)(30例)三个小组。采用酶联免疫吸附法分别测定血浆TF、TFPI、IL-18、IL-10的含量。结果 CHD组患者血浆TF、TFPI、TF/TFPI高于对照组,AMI小组患者血浆TF、TFPI、TF/TFP显著高于UAP及SAP小组患者,UAP小组患者高于SAP小组患者;CHD组患者血浆IL-18、IL-10、IL-18/IL-10高于对照组,AMI小组患者血浆IL-18、IL-18/IL-10显著高于UAP及SAP小组患者,UAP小组患者高于SAP小组患者;AMI和UAP小组患者血浆IL-10水平低于SAP小组患者;CHD组患者血浆TF与IL-18呈显著正相关(r=0.753,P=0.03),TF/TFPI与IL-18/IL-10呈正相关(r=0.496,P=0.01)。结论 CHD患者促凝因素和促炎症因子均显著升高,且与病情平行。促凝因子和促炎因子呈正相关,提示凝血因子和炎症因子在CHD发病中起重要作用,并可作为病情严重程度评价的参考指标。

Objective To explore the changes in plasma tissue factor（TF）,tissue factor pathway inhibitor（TFPI）,interleukin-18（IL-18）,and interleukin-10（IL-10） in patients with coronary heart disease（CHD）,and to investigate their roles in the development of CHD and their mutual relationships. Methods A total of 121 patients were divided into control group （n=25） and CHD group （n=96）. CHD group was further divided into acute myocardial infarction （AMI） subgroup （n=33）,unstable angina pectoris （UAP） subgroup （n=33） and stable angina pectoris （SAP） subgroup （n=30）. Plasma TF,TFPI,IL-18,IL-10 levels were detected by enzyme-linked immunosorbent assay （ELISA）. Results The plasma concentrations of TF,TFPI and TF/TFPI ratio were higher in CHD group than in control group; they were higher in AMI subgroup than in UAP and SAP subgroups,and higher in UAP subgroup than in SAP subgroup. The plasma concentrations of IL-18,IL-10,and IL-18/IL-10 ratio in CHD group were higher than those in control group. The plasma concentrations of IL-18 and IL-18/IL-10 ratio were higher in AMI subgroup than in UAP and SAP subgroups,and higher in UAP subgroup than that in SAP subgroup. The plasma concentration of IL-10 in AMI and UAP subgroups was lower than that in SAP subgroup. In CHD group,plasma TF was positively correlated with IL-18 （r=-0.302 2,P0.01） and TF/TFPI ratio was also positively associated with IL-18/IL-10 （r=0.3494,P=0.01）. Conclusion Hypercoagulability activity and high inflammatory response exist in CHD patients; further more,they parallel with the severity of the disease. The positive relationship between coagulation factors and inflammatory factors suggests that they play an important role in the development of CHD and be used to evaluate the severity of the disease.