白介素-18与冠状动脉钙化及粥样硬化斑块性质的相关性研究

Association between interleukin-18 and coronary calcium score in coronary artery disease

目的探讨白介素-18与冠状动脉钙化及粥样硬化斑块性质的相关性。方法 100例临床疑似或者确诊冠心病患者,记录年龄、性别、吸烟、体重指数(BMI)、血压,检测血脂、血糖和血清IL-18水平;行128层螺旋CT(MSCT)冠状动脉扫描,记录冠状动脉钙化程度的钙化积分(CACS)和粥样硬化斑块性质及数量;分析IL-18及其他危险因素与CACS的相关性,不同性质斑块各组间IL-18水平的差异,检测不同数量软斑块组IL-18水平的差别。结果多因素Logistic回归分析发现,IL-18与CACS呈负相关性(P=0.035);年龄和男性与CACS呈正相关(P=0.017,P=0.031)。有软斑块组的IL-18较无斑块组及单纯钙化斑块组显著升高,单纯钙化斑块组与无斑块组IL-18水平差异有统计学意义,不同数量软斑块组IL-18水平差异有统计学意义。结论 IL-18是反映斑块不稳定的有效炎性指标,单纯斑块钙化不会引起IL-18增高,IL-18与CACS呈负相关,因此冠状动脉钙化不增加斑块破裂风险,可能起到维持斑块稳定性的作用。

Objective To investigate the association between IL-18 and coronary calcium score in coronary artery disease,and ascertain the difference of IL-18 among the patients with atherosclerotic soft plaque and fibrous plaque and calcified plaque,moreover,the different IL-18 level of patients who have different number of soft plaque was identified.Methods The study population was consist of 100 patients with coronary artery disease.Age,gender,smoking status,BMI and blood pressure were recorded.Blood lipid,glucose and IL-18 were detected.Coronary calcium scoring was done by 128 slice spiral CT scan.Atherosclerotic plaques were defined of soft plaque and fibrous plaque and calcified plaque according to density.The correlation of factors and CACS were analysed,and difference of IL-18 level among the patients with different plaque were detected.Results There was significant inverse correlation between IL-18 and CACS according to multiple factor regression analysis （P=0.035）,and there was significant positive correlation between age,gender and CACS.IL-18 level in the group with soft plaque was significant high.Conclusions IL-18 level was not high in the group with pure calcified plaque.Inverse correlation between IL-18 and CACS was significant.So,we conclude,that CAS maybe increase the stability of atherosclerotic plaques.