巨噬细胞集落刺激因子与不稳定型心绞痛患者预后的关系

Relationship between serum macrophage colony stimulating factor levels and subsequent heart events in unstable angina

目的 :评价巨噬细胞集落刺激因子 (MCSF)预测不稳定型心绞痛 (UAP)患者预后的价值。方法 :118例接受了冠状动脉造影或有心肌梗死史的BrauwaldⅢB型UAP患者纳入本研究。检测入选者血清MCSF、白细胞介素 6 (IL 6 )、C 反应蛋白 (CRP) ,并对其进行了 6个月的随访 ,按随访期间有无主要心脏事件发生分成两组 :Ⅰ组 :发生心脏事件 (n =6 8) ;Ⅱ组 :未发生心脏事件 (n =5 0 )。结果 :Ⅰ组患者血清MCSF、IL 6、CRP均显著高于Ⅱ组患者 [MCSF :(4 5 7.19± 6 6 .16 )∶(311.14± 4 8.2 2 )ng/L ;IL 6 :(8.6 8± 4 .6 1)∶(4 .5 9± 1.71)ng/L ;CRP :(8.6 9± 3.73)∶(3.34± 2 .0 8)mg/L ;三者均P <0 .0 1]。血清MCSF含量与IL 6 (r =0 .5 2 1,P <0 .0 1)和CRP(r =0 .5 2 8,P <0 .0 1)含量均呈显著正相关。多因素回归分析显示 ,血清MCSF水平是UAP随访期间发生心脏事件独立的、最强烈的预测因子 (P <0 .0 1)。结论 :UAP患者血清MCSF浓度增高时 。

Objective:To assess the prognostic value of macrophage colony stimulating factor (MCSF) in unstable angina pectoris(UAP).Methods:One hundred and eighteen patients with UAP documented by angiography or previous myocardial infarction were involved in this study. Serum concentrations of MCSF, interlukin-6 (IL-6) and C-reactive protein (CRP) were measured. Patients were divided into two groups according to 6-month follow-up outcome: group Ⅰcomprised 68 patients with an eventful course, and group Ⅱ comprised 50 patients without an event.Results:The levels of MCSF, IL-6 and CRP were significantly elevated in group Ⅰthan that in group Ⅱ [MCSF:( 457.19 ± 66.16)vs( 311.14± 48.22)ng/L;IL-6:( 8.68± 4.61)vs( 4.59± 1.71)ng/L;CRP:( 8.69± 3.73)vs( 3.34± 2.08)mg/L;P< 0.01)]. There was a positive correlation between MCSF with IL-6 (r= 0.521,P< 0.01) and CRP (r= 0.528,P< 0.01) concentrations. In the multivariate analysis, MCSF concentrations were the most powerful predictor of outcome.Conclusion:This study suggests that increased concentrations of MCSF predict a worse long term prognosis in patients with UAP.