急性冠脉综合征患者炎性因子水平变化及其与室性心律失常的关系研究

Changes of Inflammatory Cytokines of Acute Coronary Syndrome Patients and the Correlations with Ventricular Arrhythmia

目的分析急性冠脉综合征患者炎性因子水平变化及其与室性心律失常的关系。方法选取2014年5月—2015年8月连云港市第一人民医院心血管内科收治的急性冠脉综合征患者80例,其中不稳定型心绞痛26例(A组),急性非ST段抬高型心肌梗死27例(B组),急性ST段抬高型心肌梗死27例(C组);继发室性心律失常50例,未继发室性心律失常30例。检测所有患者炎性因子〔肿瘤坏死因子α(TNF-α)、超敏C反应蛋白(hs-CRP)、白介素6(IL-6)、CD_(40)配体〕水平,并分析其与室性心律失常患者Lown分级的相关性。结果 B、C组患者TNF-α、hs-CRP、IL-6、CD_(40)配体水平高于A组,C组患者TNF-α、hs-CRP、IL-6水平高于B组,CD_(40)配体水平低于B组(P<0.05)。未继发室性心律失常患者TNF-α、hs-CRP、IL-6、CD_(40)配体水平低于继发室性心律失常者(P<0.05)。不同Lown分级室性心律失常患者TNF-α、hs-CRP、IL-6、CD_(40)配体水平比较,差异有统计学意义(P<0.05)。Spearman秩相关性分析结果显示,TNF-α、hs-CRP、IL-6、CD_(40)配体水平与室性心律失常患者Lown分级呈正相关(rs值分别为0.767、0.813、0.796、0.396,P<0.05)。结论急性冠脉综合征继发室性心律失常患者TNF-α、hs-CRP、IL-6、CD_(40)配体水平较高,临床可通过监测上述指标判断室性心律失常严重程度。

Objective To analyze the changes of inflammatory cytokines of acute coronary syndrome patients and the correlations with ventricular arrhythmia. Methods From May 2014 to August 2015,a total of 80 patients with acute coronary syndrome were selected in the Department of Cardiovascular Medicine,the First People’ s Hospital Lianyungang,thereinto 26 cases with unstable angina pectoris were served as A1 group,27 cases with non ST-segment elevation acute myocardial infarction were served as A2 group,27 cases with ST-segment elevation acute myocardial infarction were serves as A3 group;50 cases complicated with ventricular arrhythmia were served as B1 group,other 30 cases did not complicate with ventricular arrhythmia were served as B2 group. Inflammatory cytokines including TNF-α, hs-CRP, IL-6 and CD40 ligand were detected, and the correlations with Lown’s classification were analyzed. Results TNF-α,hs-CRP,IL-6 and CD40 ligand of A2 group and A3 group were statistically significantly higher than those of A1 group, meanwhile TNF-α, hs-CRP and IL-6 of A3 group were statistically significantly higher than those of A2 group,while CD40 ligand of A3 group was statistically significantly lower than that of A2 group( P < 0. 05). TNF-α,hs-CRP,IL-6 and CD40 ligand of B1 group were statistically significantly higher than those of B2 group( P < 0. 05). There were statistically significant differences of TNF-α,hs-CRP,IL-6 and CD40 ligand in ventricular arrhythmia patients with different Lown’ s classifications( P < 0. 05).Spearman rank correlation analysis results showed that,TNF-α,hs-CRP,IL-6 and CD40 ligand was positively correlated with Lown’ s classification in patients with ventricular arrhythmia,respectively( rs= 0. 767,0. 813,0. 796,0. 396;P < 0. 05). Conclusion TNF-α,hs-CRP,IL-6 and CD40 ligand of acute coronary syndrome patients complicated with ventricular arrhythmia are significantly elevated,detection of above index is helpful to predict the severity of ventricular arrhythmia.