血清炎性细胞因子、胆红素、尿酸与急性冠脉综合征的关系研究

Clinical Correlation between Serum Inflammatory Cytokines,Bilirubin,Uric Acid and Acute Coronary Syndrome

目的:探讨血清炎性细胞因子、总胆红素(TBIL)、尿酸(UA)在急性冠状动脉综合征(ACS)发生发展中的作用。方法:入选对象经临床及冠脉造影检查明确诊断后分为急性心肌梗死(AMI)组35例、不稳定型心绞痛(UAP)组41例、稳定型心绞痛(SAP)组40例和对照组36例。检测各组血清基质金属蛋白酶-9(MMP-9)、高敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、TBIL、UA及血脂等生化指标变化。结果:与SAP组及对照组比较,AMI组和UAP组血清MMP-9、TNF-α、hs-CRP、TBIL及UA均明显升高,差异有统计学意义(P<0.05);SAP组与对照组比较,仅血清hs-CRP升高,差异有统计学意义(P<0.05)。结论:血清MMP-9、hs-CRP和TNF-α水平的升高可作为提示斑块不稳定的标志;血清UA、TBIL升高提示机体应激情况下氧化程度加重,同时代偿性抗氧化能力亦加强。

Objective：To investigate the role of serum inflammatory cytokines, total bilirubin （TBIL） and uric acid （UA） in the development of acute coronary syndrome （ACS）. Methods： All of the enrolled patients were diagnosed by clinical features and coronary angiography. The subjects were divided into four groups, acute myocardial infarction （AMI） group （n=35）, unstable angina pectoris （UAP） group （n=41）, stable angina pectoris （SAP） group （n=40） and control group （n=36）. The serum levels of matrix metalloproteinase-9（MMP-9）, high-sensitivity C-reactive protein （hs-CRP）, tumor necrosis factor-α （TNF-α）, TBIL and UA were measured and analyzed between groups. Results： Compared with SAP and control groups, serum levels of MMP-9, TNF-α , hs-CRP, TBIL and UA were significantly increased in AMI group and UAP group （P 〈 0.01）. The serum level of hs-CRP was significantly higher in SAP group than that of control group （P 〈 0.05）. Conclusion： The increased serum levels of MMP-9, hs-CRP and TNF-α can be used as the indicator of atherosclerotic plaque instability. The increased serum levers of uric acid and TBIL may suggest the increased oxidative activities, and improved anti-oxidative activities in the acute coronary syndrome.