老年急性冠状动脉综合征合并糖尿病患者血浆白细胞介素33变化的临床意义

目的 研究老年急性冠状动脉综合征(acute coronary syndrome，ACS)合并糖尿病(diabetes mellitus，DM)患者血浆白细胞介素33(interleukin 33，IL-33)水平变化与ACS相关性。 方法 选取本院年龄≥65岁的住院患者188例行冠脉造影检查，男性105例,女性83例，平均年龄(70.8±4.4)岁。将其分为3组:ACS合并糖尿病者为糖尿病组(64例)，ACS不合并糖尿病者为非糖尿病组(73例)，冠脉造影正常且不合并糖尿病者为正常对照组(51例)。应用酶联免疫吸附法检测血浆IL-33浓度。采用Gensini评分对每支血管病变狭窄程度进行定量计算。 结果 血浆IL-33浓度在糖尿病组较非糖尿病组、非糖尿病组较对照组均升高，差异均有统计学意义(P<0.01)。糖尿病组多支血管病变者明显高于非糖尿病组,而单支血管病变者少于非糖尿病组，差异均有统计学意义(P<0.01),且糖尿病组多支血管病变者IL-33浓度明显高于单支病变者。糖尿病组和非糖尿病组患者Gensini评分值与血浆IL-33水平均呈正相关(r=0.663，P<0.01)。 结论 老年ACS患者血浆IL-33水平明显升高，且升高水平与冠脉病变程度有关，提示老年ACS患者的血管内皮存在炎症反应，合并糖尿病时加重。 

Clinical significance of plasma interleukin 33 changes in elderly acute coronary syndromes complicated with diabetic mellitus

Objective To detect the interleukin 33 level in elderly acute coronary syndromes(ACS) complicated with diabetic mellitus (DM) and to explore the relationship between IL-33 level and ACS with DM in elderly patients. Methods A total of 188 patients(age ≥ 65 years) with coronary angiography in our hospital were summarized including 105 males,averaged (70.8±4.4)years old.The patients were divided into 3 subgroups:Control group(n=64 normal subjects),ACS without DM group(n=73) and ACS+DM group(n=51).Plasma IL-33 levels were measured by ELISA and the vascular stenosis degree was quantitatively calculated with Gensini score. Results The IL-33 levels in ACS+DM group were significantly higher than those in ACS without DM group(P<0.01),and the IL-33 levels in ACS without DM group were significantly higher than those in the control group(P<0.01).Compared with ACS without DM group,the ACS+DM group had more patients with multiple vascular lesions and less patients with single vascular lesions(P<0.01).The Gensini score was positively related to IL-33 level in both ACS+DM group and ACS without DM group(r=0.663,P<0.01). Conclusion The plasma IL-33 level is high in elder ACS patients and the elevation level is related to vascular lesion degree complicated with DM,which indicate that the inflammatory reaction mat be present in vascular endothelial with those patients.