摘要
目的通过测定急性冠状动脉综合征（ACS）患者血浆白细胞介素33（interleukin-33，IL－33）的浓度，进一步探讨其与冠状动脉病变严重程度及预后的关系。方法收集60例ACS患者[其中不稳定型心绞痛（UAP）、非ST段抬高性心肌梗死（NSTEMI）、ST段抬高性心肌梗死（STEMI）患者各20例]和20例非冠心痛患者（对照组）入院时的血浆，以及从STEMI组中选择13例接受直接经皮冠状动脉介入治疗（PCI）的患者经强化冠心病二级预防药物治疗3个月时的血浆，采用酶联免疫吸附测定（euzymelinked immunosorbent assay，ELISA）法检测IL－33的浓度。结果ACS患者各亚组血浆IL－33浓度显著低于对照组，分别为（42．56±10．17）ng／L、（40．65±12．99）ng／L、（30．46±4．97）ng／LVS（56．66±5．09）ng／L（均P〈0．01）。logistic回归分析发现，血浆IL－33浓度降低是冠状动脉病变和斑块不稳定的独立危险因素（OR＝0．245，95％CI0．158～0．442，P＝0．002）。冠心病危险因素相关分析显示，血浆IL-33水平与空腹血糖、甘油三酯（TG）呈负相关。13例STEMI患者经直接PCI及药物治疗3个月后，血浆IL-33浓度显著回升（46．47±12．33）ng／Lvs（29．45±3．01）ng／L（P=0．001）。结论血浆IL-33水平与ACS严重程度和斑块稳定性独立相关，与空腹血糖、TG也有明确关系，同时与冠心病的预后也有一定关联，因此IL-33有望作为冠心病早期诊断和判断预后的血浆标志物之一。
Objective To assess the association of plasma interleukin-33（IL-33） level with the prognosis in the patients with acute coronary syndrome（ACS）. Methods The plasma concentration of IL-33 in 60 cases of the patients with ACS （including 20 cases with unstable angina pectoris, 20 cases with non-ST-segment elevation myocardial infarction and 20 cases with ST-segment elevation myocardial infarction） at the day of admission and 20 cases of non- coronary heart disease patients （control group） were measured using enzyme-linked immunosorbent assay. The plasma concentration of IL-33 in 13 cases of post-directing PCI-patients with STEMI was also obtained using the same method after three months of intencified medical therapy. Results The plasma concentration of IL-33 in subgroups of ACS patients was significantly lower than that in control group, （42.56±10.17） ng/L, （40.65±12.99） ng/L, （30.46±4.97） ng/L vs （56.66±5.09） ng/L（all P 〈0.01）. Logistic analysis indicated that the lower level of IL-33 was an independent risk factor for ACS （ OR = 0. 245,95% CI 0. 158 - 0. 442, P = 0. 002）. The concentrations of IL-33 correlated inversely with fasting blood glucose and triglyceride. IL-33 level of 13 STEMI patients increased dramaticly after percutaneous coronary intervention and three months of medical therapy （46.47±12.33） ng/L vs （29.45±3.01） ng/L（ P =0. 001）. Conclusion The decreased plasma IL-33 concentration might be an independent risk factor for the vulnerable plaques and the severity of coronary lesions, and could be used as one of the independent predictors for the prognosis in patients with ACS.
出处
《临床荟萃》
CAS
2009年第11期924-927,共4页
Clinical Focus
