冠心病患者血清白介素-17与血管假友病因子、C-反应蛋白水平及冠脉病变程度的相关性

目的探讨冠心病患者血清白介素-17（IL-17）与血管假友病因子（vWF）、C-反应蛋白水平（CRP）及冠脉病变程度的相关性。方法选择2012年6~9月苏州大学附属第三医院治疗的冠心病患者65例为冠心病组,选择同期冠状动脉造影（CAG）正常或微小病变〈50%除外冠心病者25例为对照组;冠心病组分为稳定型心绞痛患者（SAP组）23例,不稳定型心绞痛患者（UAP组）14例,急性心肌梗死患者（AMI组）28例;采用酶联免疫分析法（ELISA）检测各组血清中IL-17、vWF水平,采用免疫散射比浊法检测CRP水平。采用Gensini评分系统评价冠脉病变程度;分析IL-17与vWF、CRP及Gensini评分的相关性。结果①AMI组白细胞计数（7.93±2.86）×109/L]高于SAP组（6.33±1.53）×109/L]、UAP组（7.50±2.39）×109/L]及对照组（6.50±1.39）×109/L],差异均有统计学意（P=0.027）;SAP组、UAP组、AMI组Gensini评分25.80（3.00,68.00）、25.25（4.00,116.00）、36.00（4.00,100.00）分]高于对照组1.84（0.00,11.00）分],差异有高度统计学意义（P=0.001）。②AMI组、UAP组、SAP组患者血清IL-17、vWF及CRP水平与对照组比较,差异均有统计学意义（P〈0.01）;AMI组、UAP组、SAP组间血清IL-17、vWF水平差异均有高度统计学意（P〈0.01）;SAP组与对照组血清CRP水平比较,差异无统计学意义（P〉0.05）。而AMI组、UAP组CRP水平（15.13±8.59）、（8.36±3.08）mg/L]均高于对照组（3.67±0.43）mg/L],差异均有统计学意义（P〈0.01）。③经直线相关与回归分析,IL-17分别与vWF（r=0.610,P〈0.01）、CRP（r=0.568,P〈0.01）成正相关,IL-17与Gensini评分亦成正相关（r=0.438,P〈0.01）。结论 IL-17、vWF、CRP参与了冠心病的发生发展过程,IL-17可促进vWF、CRP产生,并与冠脉病变的严重程度相关。

The correlation between IL-17 with serum vWF, CRP and the severity of coronary lesion in patients with coronary heart disease

Objective To investigate the correlation between IL-17 with serum vWF,CRP and the severity of coronary lesion in patients with coronary heart disease.Methods 65 patients with coronary heart disease from June 2012 to September in 2012 in the Third Affiliated Hospital of Soochow University were selected as coronary heart disease group,25 cases of normal coronary angiography（CAG） or minimal lesion ＆lt;50% except for coronary heart disease were selected as control group.Coronary heart disease group was divided into SAP group（23 cases）,UAP group（14 cases）,AMI group（28 cases）;ELISA was used to detect the serum level of IL-17,vWF;immuno-scatter turbidmetry was used to detect the serum level of CRP.Gensini points-scoring system was used to evaluate the degree of coronary artery lesions;the correlation was analyzed among the vWF,CRP,Gensini and IL-17.Results ①The count of white blood cell in AMI group （7.93±2.86）×109/L] were higher than those in SAP group （6.33 ±1.53）×109/L],UAP group （7.50±2.39）×109/L] and control group （6.50±1.39）×109/L],the differences were statistically significant（P = 0.027）;Gensini scores in SAP group,UAP group,AMI group 25.80（3.00,68.00）,25.25（4.00,116.00）,36.00（4.00,100.00） scores] were higher than those in control group 1.84（0.00,11.00） scores],the differences were statistically significant（P = 0.001）.② The differences of the serum level of IL-17,vWF,CRP in SAP group,UAP group,AMI group and control group were all statistically significant（P ＆lt; 0.01）;the differences of the serum level of IL-17,vWF among SAP group,UAP group,AMI group were all statistically significant（P ＆lt; 0.01）;the differences of CRP in SAP group and control group was not statistically significant（P ＆gt; 0.05）.CRP level in AMI group,UAP group （15.13 ±8.59）,（8.36 ± 3.08） mg/L] were all higher than those in control group （3.67 ±0.43） mg/L],the differences were statistically significant＆lt; 0.01）,the positive correlation was found in IL-17 and Gensini scores（r = 0.438,P ＆lt; 0.01） according to the rectilinear correlation and regression analysis.Conclusion IL-17,vWF and CRP participate in the occurrence and development of coronary heart disease;IL-17 promote the production of vWF and CRP,it has closely relation with the order of severity in coronary lesion.