青年与老年急性心肌梗死患者血浆炎性因子的对比分析

The comparative analysis of plasma inflammatory factors between young and elderly patients with acute myocardial infarction

目的：检测青年（≤40岁）和老年（60 ～ 80岁）急性心肌梗死患者血浆高敏C反应蛋白（hs-CRP）、纤维蛋白原（Fib）、血浆白介素-6（IL-6）、肿瘤坏死因子-d（TNF-α）及丙二酫（MDA）的变化,并分析炎性因子与年龄的相关性及其临床意义.方法：选取我院因急性心肌梗死入院的患者300例,其中青年患者和老年患者各150例.所有患者均行冠状动脉造影检查,观察冠状动脉病变情况.并于入院即刻取静脉血5mL,通过生物化学和酶联免疫吸附实验（ELISA）方法检测血浆hs-CRP、Fib、IL-6、TNF-α及MDA的变化,并分析血浆炎性因子水平与年龄的相关性.结果：与青年组比较,老年组急性心肌心肌梗死患者高血压、糖尿病及陈旧性脑卒中比例更高（P＜0.01）;双支病变、三支病变的比例更高（P＜0.01）;血浆hs-CRP、Fib、IL-6及TNF-α水平升高更显著（P＜0.01）,血浆脂质过氧化产物丙二醛含量更高（P＜0.01）.结论：血浆炎症因子与急性心肌梗死患者年龄相关.其原因可能与老年患者基础病多,累及病变血管多、血浆过氧化损伤严重有关.

Objective： To investigate the level of plasma hs-CRP, Fib, IL-6, TNF-ct and MDA in young （ ≤40 years old） and elderly（60 -80 years old） patients with acute myocardial infarction, and ana- lyse the correlation between the level of plasma inflammatory cytokines and ages. Methods：We ehoosed 300 patients with acute myocardial infarction Anzhen Hospital including 150 young patients and 150 elderly pa- tients. All the patients underwent percutaneous coronary angiography, and coronary artery lesions were ob- served. And 5ml venous blood was obtained from all the patients at the time of admission, and then plasma were separated. The level of plasma hs-CRP, Fib, IL-6, TNF-α, MDA were investigated by Biochemistry and ELISA.. Results： Compared with young group, the ratio of hypertension, diabetes, chronic stroke was higher in elderly patients（ P 〈0. 01 ） , the ratio of double and three vessel coronary artery disease were increased（ P 〈 0.01 ） , and the level of plasma hs-CRP, Fib, IL-6, TNF-α, M DA were higher（ P 〈 0.01 ）. And plasma lipid peroxidation product M malondialdehyde content is higher in elderly patients （P 〈 0.01 ）. Conclusion：The level of plasma inflammatory factors are associated with the age of patients with acute myocardial infarction. The reason may be correlated with more basic diseases, multiple vascular lesion and serious oxidative damage in elderly patients.