不稳定型心绞痛患者血清细胞因子与基质金属蛋白酶-2的关系

Relation between inflammatory cytokines and matrix metalloproteinase-2 in patients with unstable angina

目的:探讨不稳定型心绞痛(UAP)患者血清致炎因子(IL-1、IL-6、TNF-α)、抗炎因子(IL-10)水平与基质金属蛋白酶-2(MMP-2)及其抑制剂(TIMP-2)的关系。方法:选择UAP患者135例(UAP组)、稳定型心绞痛(SAP)患者35例(SAP组)、对照组30例,应用ELISA法检测血清IL-1、IL-6、TNF-α、IL-10、MMP-2、TIMP-2水平。结果:UAP组患者血清IL-1、IL-6、TNF-α、IL-10、(IL-1+IL-6+TNF-α)/IL-10、MMP-2、TIMP-2、MMP-2/TIMP-2水平高于对照组及SAP组(P均<0.05);Spearson相关分析显示,UAP患者血清MMP-2活性与IL-1、IL-6、IL-10、TNF-α水平正相关(P<0.05);多元逐步回归分析显示,UAP患者血清MMP-2与IL-1、(IL-1+IL-6+TNF-α)/IL-10、空腹血糖独立正相关。结论:UAP患者致炎与抗炎细胞因子平衡失调,可能通过影响MMP-2活性介导斑块向不稳定性进展,促进UAP的发生。

Objective： To elucidate the relationship among pro-inflammatory cytokine（IL-1,IL-6,TNF-α）,anti-inflammatory cytokine（IL-10） and MMP-2 and their effects on the stability of plaque in unstable angina.Methods： The concentrations of IL-1,IL-6,TNF-α,IL-10,MMP-2 and TIMP-2 were analyzed using ELISA in 170 patients and 30 healthy control subjects.Patients were divided into two groups,stable angina（n=35） and unstable angina（n=135）.Results： The serum levels of IL-1,IL-6,TNF-α,IL-10,MMP-2 and TIMP-2 were significantly higher in UAP group and SAP group compared with the healthy control group（P0.05）,and so were the ratio of MMP-2/TIMP-2 and（IL-1＋IL-6＋TNF-α）/IL-10（P0.05）.The levels of above mentioned cytokines and ratios in patients with unstable angina were significantly higher than those with stable angina（P0.05）.Correlation analysis revealed the level of MMP-2 was positively related to the levels of IL-1,IL-6,IL-10 and TNF-α.In multiple linear regression analysis,significant positive correlations were found between MMP-2 and IL-10,（IL-1＋IL-6＋TNF-α）/IL-10 and fasting blood glucose separately in patients with unstable angina.Conclusion： The imbalance of proinflammation/anti-inflammation could lead to unstability of the plaque through the regulation of MMP-2,which could trigger unstable angina.