单核细胞趋化蛋白1肿瘤坏死因子α与冠状动脉斑块易损性的相关性研究

Correlation between monocyte chemoattractant protein 1 and tumor necrosis factorαwith vulnerability of coronary atherosclerotic plaques

目的探究单核细胞趋化蛋白-1(MCP-1)和肿瘤坏死因子α(TNF-α)与冠状动脉斑块易损性的相关性及其对于冠心病不稳定性斑块的诊断价值。方法选取2010年8月至2016年8月河南省人民医院收治的经冠状动脉造影(CAG)检查确诊的98例冠心病患者为研究对象,根据冠状动脉内超声显像(IVUS)的结果分为不稳定性斑块组(53例)和稳定性斑块组(45例)。选择该院同期健康体检者50例为对照组。比较3组患者血浆MCP-1、TNF-α水平,分析其与冠心病传统危险因素的相关性,采用受试者工作特征(ROC)曲线分析MCP-1、TNF-α对于冠心病不稳定性斑块的诊断价值。结果不稳定性斑块组血浆MCP-1和TNF-α水平显著高于稳定性斑块组(P<0.05),且不稳定性斑块组及稳定性斑块组上述指标水平均显著高于对照组(P<0.05);MCP-1水平与年龄、尿酸、体质量指数(BMI)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、TNF-α、肌酸激酶同工酶(CK-MB)呈正相关(r=0.203、0.169、0.189、0.187、0.258、0.437、0.696),TNF-α水平与尿酸、BMI、TC、LDL-C、CK-MB呈正相关(r=0.133、0.153、0.362、0.586、0.411),与高密度脂蛋白胆固醇(HDLC)呈负相关(r=-0.351);MCP-1、TNF-α单项检测冠心病不稳定性斑块的灵敏度分别为0.833、0.893,但联合检测的灵敏度更高,可达0.909。结论血清MCP-1、TNF-α对于冠状动脉斑块易损性具有一定的诊断价值,有望成为新的判断冠心病斑块性质的指标。

Objective To explore the correlation between monocyte chemoattractant protein 1（MCP-1）and tumor necrosis factorα（TNF-α）with vulnerability of coronary atherosclerotic plaques and their diagnostic value in unstable plaques of coronary heart disease.Methods A total of 98 patients with coronary heart disease diagnosed by coronary angiography（CAG）in our hospital from August 2010 to August 2016 were selected as the research subjects and divided into the unstable plaques group（53 cases）and stable plaques group（45 cases）according to the IVUS results.At the same time,50 persons undergoing healthy physical examination were selected as the control group.The levels of plasma MCP-1 and TNF-αwere compared among the three groups,and their correlation with the traditional risk factors of coronary heart disease was analyzed.The ROC curve was adopted to explore the diagnostic value of MCP-1 and TNF-αin unstable plaque of coronary heart disease.Results The levels of plasma MCP-1 and TNF-αin the unstable plaques group were significantly higher than those in the stable plaques group（P〈0.05）,moreover the levels of plasma MCP-1 and TNF-αin the unstable plaques group and stable plaques group were significantly higher than those in the normal control group（P〈0.05）;the level of MCP-1 was positively correlated with age,uric acid,BMI,TC,LDL-C,TNF-αand CK-MB（r=0.203,0.169,0.189,0.187,0.258,0.437,0.696）,and the level of TNF-αwas positively correlated with uric acid,BMI,TC,LDL-C and CK-MB（r=0.133,0.153,0.362,0.586,0.411）,and was negatively correlated with HDL-C（-0.351）;the sensitivity of single MCP-1 and TNF-αfor detecting unstable plaque of coronary artery disease were 0.833 and 0.893 respectively,but the sensitivity of their combined detection was higher,which was up to 0.909.Conclusion Serum MCP-1 and TNF-αhave a certain diagnostic value for the vulnerability of coronary atherosclerotic plaques,which are expected to become the indicators for judging the nature of coronary atherosclerotic plaques.