冠心病患者血清细胞因子水平及临床意义

Levels and clinical value of serum cytokines in patients with coronary heart disease

目的：检测冠心病（coronary heart disease,CHD）患者血清中血管细胞黏附分子（vascular cell adhesion molecule,VCAM）-1、白细胞介素（interleukin,IL）-8、IL-11、干扰素诱导蛋白（interferon inducible protein,IP）-10、巨噬细胞炎症蛋白（macrophage inflammatory protein,MIP）-1β、调节正常T细胞表达和分泌的细胞因子（RANTES）、血管生成素（Angiogenin）7种细胞因子的含量,研究7种细胞因子与疾病严重程度和冠状动脉病变特点之间的关系,探讨其作为新的CHD标记物的可能性。方法：本研究入选216例患者,其中CHD组158例,对照组58例。检测两组血清中7种细胞因子的含量,并进行统计分析。结果：①CHD组与对照组的IL-8、IP-10、MIP-1β、RANTES血清水平比较无统计学差异;而CHD组血清VCAM-1、IL-11、Angiogenin水平高于对照组,差异有统计学意义（P〈0.05）;②单支病变、双支病变和多支病变亚组之间的VCAM-1、IL-11水平没有差异（P〉0.05）,而多支病变组的血清Angiogenin水平高于双支病变组和单支病变组（P〈0.05）;③Gensini积分为0-20分、21-40分、〉40分的3个亚组之间血清VCAM-1、IL-11水平差异没有统计学意义（P〉0.05）;Gensini积分〉40分亚组的血清Angiogenin水平高于21-40分亚组（P〈0.05）,21-40分亚组的血清Angiogenin水平高于0-20分亚组（P〈0.05）;④血清Angiogenin水平与Gensini积分呈正相关（r=0.270,P=0.046）,与传统CHD危险因素无相关性（P〉0.05）。结论：VCAM-1、IL-11、Angiogenin 3种细胞因子在CHD患者血清中表达增加,血清Angiogenin水平可以间接反映冠脉狭窄的范围和程度。

Objective：To investigate the serum levels of vascular cell adhesion molecule-1（VCAM-1）,interleukin-8（IL-8）,interleukin-11（IL-11）,interferon-inducible protein-10（IP-10）,macrophage inflammatory protein-1β（MIP-1β）,the regulated upon activation normal T cell expressed and secreted（RANTES）,and angiogenin in patients with coronary heart disease（CHD）,then analyze the relationship between the 7 cytokines and the characteristic of coronary artery and explore the possibility to treat them as the new biomarker of CHD.Methods：A total of 216 patients were enrolled in this study.The CHD group consisted of 158 patients who were diagnosed with CHD and the control group consisted of 58 patients with normal coronary artery.Serum levels of the seven cytokines were measured and analyzed.Results：①No significant difference was detected in the levels of IL-8,IP-10,MIP-1β and RANTES between the CHD group and the control group,while the levels of VCAM-1,IL-11 and angiogenin in the CHD group were significantly higher than those in the controls（P〈 0.05）.②The differences of the serum levels of VCAM-1 and IL-11 were not significant among the single vessel subgroup,two vessels subgroup and the multiple vessels subgroup（P〈 0.05）,while the levels of angiogenin in the multiple vessels group were significantly higher than those in the single vessel subgroup and two vessels subgroup（P〈 0.05）.③ The differences of the serum levels of VCAM-1 and IL-11 were not significant among the subgroups with Gensini severity score 40,21~40 and 20,respectively.Serum levels of angiogenin in the subgroup with Gensini severity score 40 were significantly higher than those in the subgroup with the score between 21 and 40（P〈 0.05）,and the levels in the subgroup with the score between 21 and 40 were significantly higher than those in the subgroup with the score 20（P〈 0.05）.④The level of serum angiogenin was positively related with the Gensini severity score（r = 0.27,P = 0.046）.Linear correlation analysis revealed that serum level of angiogenin was not associated with risk factors of CHD（P〈 0.05）.Conclusion：The expressions of VCAM-1,IL-11and angiogenin increase in the serum of patients with coronary heart disease.The serum level of angiogenin may be a potential biological indicator to evaluate the degree of coronary artery stenosis.