冠脉斑块稳定性与肿瘤坏死因子相关研究

目的 探讨肿瘤坏死因子(Tumor necrosis fac-tor-alpha,TNF-α)与冠状动脉粥样硬化斑块稳定性的相关性。方法 以血管内超声(Intravascular Ultrasound,IVUS)检出冠状动脉粥样硬化斑块的软硬特性,通过临床是否为急性冠脉综合征患者,将具有软斑块特性,同时急性冠脉综合征者分为不稳定斑块组;而硬斑块特性,且不符合急性冠脉综合征者为稳定斑块组。测定两组间冠状窦及外周血血浆TNF-α浓度,结果与IVUS测定的斑块大小、斑块纤维帽厚度、脂核或无回声带大小、脂核或无回声带/斑块比及面积狭窄率进行相关性分析。结果 不稳定斑块组TNF-α值明显高于稳定斑块组(o.11o±O.045)ng/mL vs(0.097±0.137)ng/mL,P<0.01和(0.111±0.037)ng/mL vs(0.042±0.022)ng/mL,P<0.05;将测得TNF-α与IVUS所测得纤维帽厚度、脂核或无回声带大小、斑块大小、脂核/斑块、面积狭窄率等进行相关分析,未见明显相关。结论TNF-α与斑块的稳定性有关,同时其在冠状循环与体循环中的量无差异,可望作为冠脉斑块不稳定性的判定指标。

Study on the relationship between coronary atherosclerotic plaque stability and Tumor necrosis factor-alpha

Objectives To investigate the correlation between Tumor necrosis factor-alpha (TNF-a) and coronary atherosclerotic plaque stability. Methods 22 patients with acute coronary syndromes and soft plaque by FVUS were categorized as vulnerable plaque group and 12 patients with no acute coronary syndromes and hard plaque as stable plaque group. The plasma level of TNF-a was determined and correlation analysis was done between plasma levels of TNF-a and plaque fibrous cap tinckness, emptied plaque or lipid corr size, lipid to plaque ratio, plaque area stenosis detected by IVUS. Results The plasma level of TNF- a was shown greatly ingher in vulnerable plaque group than in stable plaque group (0.110 + 0.045) ng/mL vs (0.097 +0.137) ng/mL, P < 0.01 and (0. Ill + 0.037) ng/mL vs (0.042 + 0.022) ng/mL, P < 0.05] . No correlation was found between plasma TNF-a level and plaque fibrous cap tinckness, emptied plaque or lipid core size, lipid to plaque ratio, plaque area, plaque area stenosis. Conclusions TNF-a, intensively associated with the unstability of atherosclotic plaques and had no difference both coronary and systemic circulation, could be used as indices for the identification of plaque unstability.