不同炎性标志物对冠状动脉病变的预测价值

Different Inflammatory Markers Differ in Predicting the Severity and Instability of Coronary Artery Disease

目的探讨可溶性CD40L、单核细胞趋化蛋白1、白细胞介素8和白细胞介素6等炎性标志物对冠状动脉病变严重程度和稳定性的预测价值。方法应用流式细胞术检测129例冠心病患者血浆可溶性CD40L、单核细胞趋化蛋白1、白细胞介素8和白细胞介素6水平,计算各类型冠心病患者冠状动脉病变的Gensini积分,分析上述炎性标志物与Gensini积分的相关关系以及对急性冠状动脉综合征的预测价值。结果四种炎性标志物血浆浓度在冠心病组均显著高于对照组(P均<0.01),其中可溶性CD40L、单核细胞趋化蛋白1和白细胞介素6的浓度在急性心肌梗死组高于稳定型心绞痛组(P=0.001、P=0.009和P=0.011)。血浆单核细胞趋化蛋白1和白细胞介素6水平与冠状动脉Gensini积分呈正相关关系(r=0.322,P<0.00001;r=0.203,P=0.026);多因素Logistic回归分析显示白细胞介素6对急性冠状动脉综合征有预测价值(OR=1.275,P=0.037)。结论血浆可溶性CD40L、单核细胞趋化蛋白1、白细胞介素8和白细胞介素6等炎性标志物与冠状动脉粥样硬化病变有关;血浆单核细胞趋化蛋白1和白细胞介素6能反映冠状动脉病变的严重程度;白细胞介素6对预测冠状动脉病变不稳定的冠心病急性冠状动脉综合征有一定价值。

Aim To investigate the predicting value of plasma levels of soluble CD40L（sCD40L）,monocyte chemotactic protein-1（MCP-1）,interleukin-8（IL-8）,and interleukin-6（IL-6） for the severity and instability of coronary artery disease. Methods sCD40L,MCP-1,IL-8 and IL-6 were measured in 129 cases of coronary artery disease patients,including 39 stable angina pectoris,43 unstable angina pectoris and 47 acute myocardial infarction,using flow cytometric method.Gensini scores were evaluated for each patient.Correlation of the above inflammatory factors with Gensini scores was analyzed.The predicting value of the above biomarkers for acute coronary syndrome was investigated. Results Concentrations of the tested inflammatory factors were higher in all the three coronary artery disease groups than those in contrast（all P〈0.01）.Concentrations of sCD40L,MCP-1 and IL-6 were increased in acute myocardial infarction patients than stable angina pectoris patients（P=0.001,P=0.009,P=0.011,respectively）.Plasma concentrations of both MCP-1 and IL-6 manifested positive correlation with Gensini scores（r=0.322,P〈0.00001;r=0.203,P=0.026,respectively）.Multiple Logistic regression analysis showed that IL-6 could predict acute coronary syndrome（OR=1.275,P=0.037）. Conclusion The plasma concentrations of sCD40L,MCP-1,IL-8 and IL-6 can predict the existence of atheroma;MCP-1 and IL-6 levels correlate to the severity of atheroma in coronary artery disease patients;IL-6 plays a role in predicting acute coronary syndrome.