CD40和IL-6在冠状动脉粥样硬化性心脏病稳定性中的作用

[目的]从临床、造影和血清炎性介质方面综合评估冠状动脉粥样硬化斑块的稳定性.[方法]结合临床表现、心肌酶变化、冠脉造影结果,将2010年3月-2011年3月因胸痛胸闷住院的207例患者分为急性心肌梗死组(A组,30例)、不稳定心绞痛组(B组,90例)、稳定性心绞痛组(C组,36例)和正常对照组(D组,51例).采用酶联免疫吸附法测定血清白细胞介素6(IL6)和分化抗原40(CD40).[结果]A组肌红蛋白(MYO)较D组明显升高(183.5±17.1 )ng/1 vs(43.1±27.1)ng/1,肌钙蛋白(TNI)和肌酸激酶同工酶(CKMB)无明显升高.A组IL6和CD40较对照组明显升高,分别是(289.46±143.67)pg/ml vs(147.96±118.12)pg/ml和(8.67±7.29)ng/ml vs(5.37±1.57)ng/ml,具有统计学意义(P＜0.05).线性相关分析显示MYO和IL6、CD40无明显相关,IL6和CD40呈正相关(r=0.53,P=0.042).[结论]急性心肌梗死组炎性介质水平升高,早期检验对预测斑块稳定性有一定意义.

Effects of CD40 and IL6 on the stability of coronary athrosclerotic heart disease

【Objective】 To evaluate the stability of coronary athrosclerotic plaque by clinical manifestation,coronary angiography(CAG) and the levels of serum inflammatory markers.【Methods】 A total of 207 patients with chest pain were divided into 4 groups based on the clinical manifestation,ECG changes,myocardial markers and CAG: acute myocardial infarction(group A,n = 30),unstable angina(group B,n = 90),stable angina(group C,n = 36),normal(group D,n = 51).IL6 and CD40 serum level were measured in all the patients and the myocardial markers were recorded too.【Results】 There were no difference either in TNI or CKMB level,but the MYO level was significantly increased in group A than other groups.The serum level of IL6 in group A was higher only than normal group(289.46±143.67) pg/ml vs(147.96±118.12) pg/ml(P < 0.05),and the serum level of CD40 in group A was higher than group B,group C and group D respectively(8.67±7.29) ng/ml vs(5.37±1.57) ng/ml(P < 0.05).【Conclusion】 Serum level of IL6 and CD40 can be used as a good index for reflecting the stability of coronary artery disease.