TNF-α和IL-6水平与不同类型冠心病的相关性研究

Research of Clinical Correlation between Serum Levels of TNF-α,IL-6 and Different Types of Coronary Heart Disease

目的探讨TNF-α和IL-6水平与冠心病不同表型以及冠状动脉病变程度之间的关系。方法应用酶联免疫双抗体夹心法(ELISA)测定57例冠心病患者(其中急性心肌梗死30例、不稳定型心绞痛13例、稳定型心绞痛14例)和23例正常对照组的血清TNF-α和IL-6水平。所有急性心肌梗死患者,心绞痛患者和正常对照者均行冠状动脉造影。结果 AMI组和UAP组TNF-α水平明显高于对照组(P<0.05);AMI组和UAP组IL-6水平均显著高于对照组和SAP组(P<0.05,P<0.01)。TNF-α水平与IL-6成正相关(r=0.271,P=0.042)。中度狭窄组和重度狭窄组TNF-α水平明显高于对照组和轻度狭窄组(P<0.05);IL-6水平重度组和中度组明显高于对照组(P<0.01,P<0.05),并且两组均高于轻度组(P<0.05)。结论高水平的TNF-α和IL-6可能与冠状动脉粥样斑块的发生发展与稳定性密切相关,特别是在急性冠状动脉综合征(ACS)的发生过程中扮演重要角色。

Objective To evaluate the relationship between serum levels of TNF-α, IL-6 and different clinical types of coronary heart disease （CHD） and the severity of coronary lesions. Methods By using enzyme-linked immunosorbent assay （ELISA） ,the serum levels of TNF-α and IL-6 were measured in 30 patients with AMI, 13 patients with UAP, 14 patients with SAP and 23 sub- jects without CHD（ as control）. The patients with AP or AMI and patients in the control group all underwent the coronary angioplasty（CAG）. Results Mean level of TNF-α was significantly higher in patients with AMI and UAP than those in control（ P 〈 0.05 ）. The serum levels of IL-6 were significantly increased in patients with UAP compared to the patients with SAP or control （ P 〈 0. 05 ）. The level of IL-6 in patients with AMI were also higher than those in patients with SAP and control group （ P 〈 0. 01 ）. IL-6 and TNF-α were also positively correlated in patients with CHD （r = 0.271,P = 0. 042）. Serum levels of TNF-α were higher in the severe and moderate groups than those in the control and minor groups （ P 〈 0.05 ）. Serum levels of IL-6 were higher in the severe and moderate groups than those in the control （ P 〈 0.01, P 〈 0.05 ）. Conclusion The high levels of TNF-α and IL-6 were significantly correlated with CHD, especially in the occurrence of ACS. The inflammatory response may play an important role.