老年冠心病患者感染性指标水平变化的临床研究

Changes of infected index levels in elderly patients with coronary heart disease

目的监测门诊治疗的老年冠心病患者感染性指标水平变化,探讨其临床应用价值,提高临床对老年冠心病患者的认识及治疗水平。方法选取门诊治疗的老年冠心病患者118例作为观察组,其中急性心梗死(AMI)患者39例,不稳定心绞痛(UAP)患者79例,另外选取同期健康体检者110名作为对照组;观察组患者在初诊时及门诊治疗3个月后,对照组人员于体检当天抽取清晨静脉血,分别通过增强比浊法测定和酶联免疫吸附法测定其高敏C-反应蛋白(Hs-CRP)、白介素-6(IL-6)、IL-8、IL-18、IL-20水平。结果观察组患者治疗前Hs-CRP(6.81±1.43)mg/L、IL-6(65.73±5.21)ng/L、IL-8(93.16±13.27)ng/L、IL-18(123.75±23.96)ng/L、IL-20(58.17±11.75)ng/L,治疗后分别为(3.22±1.05)mg/L、(31.36±2.99)ng/L、(74.22±11.46)ng/L、(62.28±10.35)ng/L、(33.96±7.48)ng/L,经过治疗,观察组患者上述指标较治疗前均明显下降,但仍明显高于对照组;AMI及UAP患者Hs-CRP、IL-6、IL-8、IL-18、IL-20水平均较治疗前有所降低,但AMI患者无论是治疗前还是治疗后,上述指标水平均明显低于UAP患者,差异有统计学意义(P<0.05)。结论对门诊老年冠心病患者上述感染性指标水平进行检测,可以对患者的病情有所判断,从而指导治疗方案的确定。

OBJECTIVE To monitor the changes of infected index levels in elderly outpatients with coronary heart disease and to explore its clinical value in order to improve clinical awareness of elderly patients with coronary artery disease. METHODS A total of 118 cases of elderly patients with coronary heart disease treated at outpatient clinic were selected （AMI）as observation group, in which 39 patients with acute myocardial infarction, 79 patients with unstable angina pectoris（UAP）, in addition to select healthy 110 cases at the same period as control group. The Hs-CRP, IL-6, IL-8, IL-18, IL 20 levels, samples of venous blood from the patients in observation group when they first visited at outpatient clinic and after 3 months outpatient treatment and people in control group in physical examination at morning, were measured by enhanced nephelometry assay and enzyme-linked immunosor- bent assay, respectively. RESULTS The levels were Hs-CRP （6.81 ＋ 1. 43） mg/L, IL-6 （65. 73 ＋ 5. 21） ng/L, IL-8 （93.16＋13.27）ng/L, IL-18 （123.7523.96）n/L, IL-20 （58.17＋11.75） ng / L in patients of observation group before treatment, and （3.22-＋-1.05）mg/L, （31.362.99）ng/L, （74.22＋11.46）ng/L, （62. 28 _＋10.35） ng/L, （33.96 ＋ 7.48）ng/L after treatment, which were significantly lower than those of before treatment, but still significantly higher than control group. After treatment, Hs-CRP, IL-6, IL-8, IL-18, IL-20 levels of patients with AMI and UAP were lower than those before treatment. However, these indicator levels of patients with AMI were all significantly lower than patients with UAP whether before or after treatment, and the difference was statistically significant （P （0. 05）. CONCLUSION For elderly outpatients with coronary heart disease, the measurement of above-mentioned infected indexes can help medical staff to estimate patient＇s condition and determine treatment programs.