冠心病患者动脉粥样硬化斑块特征与Th细胞漂移的关系

目的探讨急性冠状动脉综合征(ACS)患者和稳定型心绞痛(SA)患者外周血γ干扰素(INF-γ)、白细胞介素4(IL-4)、白细胞介素2(IL-2)及白细胞介素10(IL-10)水平与斑块形态特征的关系。方法 70例患者分为两组,其中ACS组37例,SA组33例,采用ELISA检测冠状动脉造影前外周血INF-γ、IL-4、IL-2及IL-10水平。根据冠状动脉造影斑块形态特征将冠状动脉斑块分为Ⅰ、Ⅱ及Ⅲ型,根据超声特点将颈动脉斑块分为易损性斑块和稳定性斑块,比较不同斑块类型者INF-γ、IL-4、IL-2及IL-10水平变化。结果 ACS患者INF-γ和IL-2水平高于SA患者(P<0.05),IL-4和IL-10水平无显著性差异。ACS患者冠状动脉斑块主要为Ⅱ型,颈动脉斑块主要为易损性斑块;SA患者冠状动脉斑块主要为Ⅰ和Ⅲ型,颈动脉斑块主要为稳定性斑块;不同斑块类型者INF-γ、IL-4、IL-2及IL-10水平不同,冠状动脉斑块Ⅱ型者INF-γ、IL-2水平较Ⅰ和Ⅲ型者显著性升高(P<0.05),而IL-4和IL-10水平无明显差异。颈动脉易损性斑块者INF-γ和IL-2水平较稳定性斑块者显著性升高(P<0.05),而IL-4和IL-10水平无明显差异。结论 Th细胞漂移和斑块特征与斑块的稳定性有关,对于冠状动脉事件有一定的预示作用。

The Relationship Between Atherosclerotic Plaque Characteristics and Th-cell Drift in the Patients with Coronary Artery Disease

Aim To determine serum levels of interferon-γ(INF-γ),interleukin-4(IL-4),interleukin-2(IL-2) and interleukin-10(IL-10) in the patients with acute coronary syndrome(ACS) and stable angina(SA),so as to investigate the relationship between plaque morphology characteristics and serum levels of INF-γ,IL-4,IL-2,and IL-10.Methods This study enrolled 37 patients with ACS and 33 patients with SA.The serum INF-γ,IL-4,IL-2 and IL-10 levels were determined by ELISA.Coronary artery plaques were divided into type I,II and Ⅲ through plaque morphology characteristics according to coronary angiography.Carotid artery plaques were divided into vulnerable plaque and unstable plaque according to ultrasound characteristics.The changes of INF-γ,IL-4,IL-2 and IL-10 levels in the patients with different plaque types were compared.Results The serum INF-γ,IL-2 levels were significantly higher in the ACS group than those in the SA group(P<0.05),but IL-4 and IL-10 levels had no significant difference.Coronary artery plaque was the main type Ⅱ and carotid artery plaque was vulnerable plaque in the ACS patients.Coronary artery plaque was the main type Ⅰ and Ⅲ and carotid artery plaque was unstable plaque in the SA patients.The plasma levels of INF-γ,IL-4,IL-2,IL-10 in different types of plaque were significantly different.The serum INF-γ,IL-2 levels in the patients of type Ⅱ coronary plaque were significantly higher than those in the patients of type Ⅰand Ⅲ coronary plaque.The serum INF-γ,IL-2 levels in the patients of carotid artery vulnerable plaque were significantly higher than those in the patients of carotid artery unstable plaque,but IL-4 and IL-10 levels had no significant difference.Conclusion Th cell drift and plaque characteristics were associated with plaque stability,and they can be used for predicting cardiovascular events.