IL-18及PAPP-A水平与冠心病患者冠脉病变程度相关性分析

Correlation Analysis between IL-18 and PAPP-A Levels and Coronary Lesion Degree in Patients with Coronary Heart Disease

目的:研究冠心病患者冠脉病变程度与血清白介素-18(IL-18)和妊娠相关血浆蛋白A(PAPP-A)之间的关系,探讨血清IL-18和PAPP-A在CHD发生发展中的可能作用以及它们在ACS早期诊断中的价值。方法:选取120例经冠状动脉造影证实的冠心病患者,其中稳定型心绞痛组(SAP组)40例、不稳定型心绞痛组(UAP组)40例、急性心肌梗死组(AMI组)40例,另选40例非冠心病患者为对照组,采用酶联免疫吸附法(ELISA)检测四组研究对象的血清IL-18与PAPP-A水平。比较冠心病不同病变程度与IL-18、PAPP-A水平的关系,以及冠状动脉Gensini评分与IL-18、PAPP-A水平的相关性。结果:AMI组与UAP组的血清IL-18、PAPP-A水平及Gensini积分均显著高于对照组与SAP组(P<0.05)。左主干病变组与三支病变组的血清IL-18、PAPP-A水平与单支病变组、双支病变组比较,差异均有统计学意义(P<0.05)。IL-18、PAPP-A水平与冠状动脉Gensini评分均呈正相关(P<0.05)。结论:血清中IL-18、PAPP-A水平与冠状动脉病变程度密切相关,可反应心肌受损的严重程度,它们有可能成为动脉粥样硬化斑块稳定性的敏感指标,对冠心病的危险分层具有重要临床意义。

Objective：To investigate the relationship between coronary lesion degree and IL-18 and PAPP-A in patients with coronary heart disease,and to explore the possible role of serum IL-18 and PAPP-A in the occurrence and development of CHD as well as their value in the early diagnosis of ACS.Method：A total of 120 patients with coronary heart disease confirmed by coronary angiography,including stable angina pectoris group （SAP group） 40 cases,unstable angina pectoris group （UAP group） 40 cases,acute myocardial infarction group （AMI group） 40 cases,and 40 cases of non coronary heart disease patients as control group,serum levels of IL-18 and PAPP-A in four groups were detected by enzyme-linked immunosorbent assay （ELISA）.The relationship between IL-18 and PAPP-A levels in different degree of coronary heart disease were compared,and coronary artery Gensini score and the correlation between PAPP-A and IL-18 levels.Result：The serum IL-18,PAPP-A levels and Gensini scores of the AMI group and UAP group were significantly higher than those in control group and SAP group （P〈0.05）.The difference of the serum IL-18,PAPP-A levels in the left main lesion group and the three lesion group were compared with the single lesion group and two lesion group,the differences were statistically significant （P〈0.05）.IL-18,PAPP-A levels were positively correlated with the Gensini score of coronary artery （P〈0.05）.Conclusion：The levels of serum IL-18 and PAPP-A are closely related with the severity of coronary artery disease,which can reflect the severity of myocardial injury,they may be sensitive indicators of the stability of atherosclerotic plaque,has important clinical significance for risk stratification in patients with coronary heart disease.