急性冠脉综合征患者血清C反应蛋白和白细胞介素10的水平及其意义

目的：探讨急性冠脉综合征（ACS）患者血清高敏C反应蛋白（hsCRP）和白细胞介素10（IL-10）水平的变化及其临床意义。方法：ACS患者48例，其中急性心肌梗塞（AMI）17例，不稳定性心绞痛（UAP）31例，稳定性心绞痛（SAP）18例，健康对照者20例，以免疫散射比浊法测定hsCRP，酶联免疫吸附法钡4定IL-10水平，ACS患者均行冠脉造影。分析冠脉病变程度与血清hsCRP、IL-10水平的关系。结果：ACS患者血清hsCRP水平明显高于SAP患者和正常对照组（P〈0．01），而血清IL—10水平明显低于SAP患者和正常对照组（P〈0．01），但AMI患者血清IL-10水平高于UAP患者（P〈0．05）；ACS患者hscRP／IL-10比值（hsCRP／IL-10比值是一种表达斑块炎症及不稳定的准确指标）明显高于SAP患者和正常对照组（P〈0．01），AMI患者的高于UAP患者，UAP的又高于SAP（P均〈0．01）；ACS患者hsCRP水平与IL-10水平成负相关（r=-0．52，P〈0．01），hsCRP和IL-10水平与冠脉狭窄程度均无相关性。结论：ACS患者血清hsCRP水平升高，IL-10水平降低，二者比例失衡。可能是冠状动脉粥样硬化斑块不稳定的标志。

Changes of serum high-sensitive C-reactive protein and interleukin-10 Levels in patients with acute coronary syndrome

Objective： To observe the changes of serum high--sensitive C--reactive protein （hsCRP） and interleukin-10 （IL-10） levels and to explore its clinical value in patients with acute coronary syndrome （ACS）. Methods： Using scatter rate nephelometry and enzyme--linked immunosorbent assay, serum hsCRP and IL-10 were measured in 48 patients with ACS, including 17 patients with acute myocardial infarction （AMI） and 31 patients with unstable angina pectoris （UAP）, 18 patients with stable angina pectoris （SAP） and 20 healthy volunteers as controls. Coronary angiography were performed in ACS patients. Results： The serum level of hsCRP in ACS group was significantly higher than that in SAP group and control group （P〈0. 01）, whereas, the serum level of IL-10 in ACS group was significantly lower than that in SAP group and control group （P〈0.01）, but the serum level of IL--10 in AMI group was significantly higher than that in UAP group （P〈0. 05）. The value of hsCRP/IL-10 in AMI patient was higher than that of UAP patient, and of UAP patient was higher than that of SAP patient （P〈0. 01 all）. There was negative correlation between hsCRP and IL-10 in patients with ACS （r= -0.52, P〈0. 01）, and there were no correlation a-mong the levels of hsCRP and IL- 10 and severity of coronary lesions. Conclusion： The serum level of hsCRP increased, and the serum level of IL- 10 decreased in ACS patients, the ratio of hsCRP to IL- 10 was imbalance, which may reflect the instability of arherosclerotic plaques.