急性冠状动脉综合征炎性反应与氧化应激相关性的临床研究

Correlation between inflammatory reaction and oxidative stress in acute coronary syndrome

目的探讨炎性反应和氧化应激在急性冠状动脉综合征(ACS)发生、发展中的机制。方法选择冠状动脉造影患者141例,根据冠状动脉造影结果分为对照组36例,稳定性心绞痛(SAP)组35例,不稳定性心绞痛(UAP)组34例和急性心肌梗死(AMI)组36例。酶联免疫吸附法检测高敏C反应蛋白(hs-CRP)、白细胞介素18(IL-18)及氧化型低密度脂蛋白(ox-LDL)指标。结果 UAP组和AMI组hs-CRP、IL-18及ox-LDL明显高于对照组和SAP组。与UAP组比较,AMI组hs-CRP、II-18及ox-LDL明显升高,差异有统计学意义(P<0.05)。相关性分析显示,控制了吸烟、高血压、糖尿病等危险因素,ox-LDL仍与hs-CRP、IL-18呈正相关(r=0.402,r=0.391,P<0.01)。结论炎性反应与氧化应激参与了ACS的发生、发展,两者相互联系,密切关联。联合两者的检测有利于早期发现ACS及进行危险分层,减少冠状动脉事件的发生。

Objective To study the mechanism of inflammatory reaction and oxidative stress underlying the occurrence and progress of acute coronary syndrome（ACS）.Methods One hundred and fourty-one patients undergoing coronary angiography were divided into control group（n=36） stable angina pectoris（SAP） group（n = 35）,unstable angina pectoris（UAP） group（n = 34） and acute myocardial infarction（AMI） group（n = 36）.Their serum levels of hs-CRP,IL-18 and ox-LDL were measured by ELIA.Results The serum hs-CRP,IL-18 and ox-LDL levels were significantly higher in UAP group and AMI group than in control group and SAP group,in AMI group than in UAP group（P〈0.05）,and increased with the progress of ACS.Correlation analysis showed that the serum ox-LDL level was positively related with the serum hs-CRP and IL-18 levels after adjustment for sex,age,diabetes mellitus,hypertension and smoking（r=0.402,r =0.391,P〈0.01）.Conclusion Inflammatory reaction and oxidative stress are involved in the occurrence and progress of ACS,which are closely related with each other.Combined detection of inflammatory reaction and oxidative stress contributes to the early diagnosis of ACS,stratification of risk,and reduction of coronary events.