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目的探讨冠心病与冠心病患者血浆同型半胱氨酸(HCY),血清白介素-6(IL-6)、C-反应蛋白(CRP)含量是否具有相关性;探讨急性心肌梗死发生时同型半胱氨酸、白介素-6、C-反应蛋白的含量是否明显升高;探讨同型半胱氨酸、白介素-6、C-反应蛋白与冠脉病变程度是否具有相关性。方法入选对象为2004年12月至2006年1月在胜利油田中心医院心内科住院疑似冠心病(CHD)、急性心肌梗塞(AMI)、心绞痛(anginapectoris)病人共92例,年龄27～77(平均57±9.66)岁。入选病人择期或急诊行冠脉造影术(CAG)检查,冠脉造影一支冠状动脉血管狭窄≥50%,诊断为冠心病。冠脉造影一支血管狭窄<50%的冠状动脉粥样硬化的患者行冠脉内超声检查,如果一支冠状动脉血管横截面积狭窄≥75%,共同组成冠心病组。共62例,年龄为34～77,平均(59.27±9.65)岁,男性53例,女性9例。冠脉造影阴性为对照组,共30例,年龄27～72,平均(54.73±9.68)岁,男性21例,女性9例。冠心病组中急性心肌梗死16例,心绞痛46例作为冠心病的2个亚组。冠脉造影结果根据冠脉病变程度不同分别为1、2、3支病变组来作为冠心病的3个亚组,对每个病人进行冠脉病变狭窄程度计分。入院第二天清晨采空腹静脉血9ml,或急诊冠脉造影术前采静脉血9ml均分3份分别送生化室及免疫室,分别用酶免法、双抗体夹心ELISA法、免疫比浊法测得同型半胱氨酸、白介素-6、C-反应蛋白水平。处理采用SPSS10.0软件包进行统计学分析。结果冠心病组血浆HCY(P<0.02);IL-6明显高于对照组(P<0.001);血清CRP明显高于对照组(P<0.002)。冠心病组中急性心肌梗死组与非梗死组之间HCY比较无统计学意义(P>0.05);IL-6明显高于非心肌梗死组(P<0.01);CRP明显高于非梗死组(P<0.01)。HCY与冠脉病变积分有相关性(r=0.277,P<0.05);CRP与冠脉病变积分有相关性(r=0.2699,P<0.05);IL-6与冠脉病变积分有相关性(r=0.343,P<0.001)。结论同型半胱氨酸、白介素-6、C-反应蛋白是冠心病危险程度预测因子,急性心肌梗死患者、IL-6、CRP明显升高,HCY、IL-6、CRP与冠脉病变严重程度相关。
Objective To investigate the correlation between plasma homocysteine (HCY), interleukin-6 (IL-6) and C-reactive protein (CRP) levels in patients with coronary heart disease and coronary heart disease (CHD) Serum IL-6, C-reactive protein levels were significantly increased; whether homocysteine, interleukin-6, C-reactive protein and coronary artery disease were related. Methods A total of 92 inpatients with suspected coronary heart disease (CHD), acute myocardial infarction (AMI) and anginapectoris were enrolled in Department of Cardiology, Shengli Oilfield Central Hospital from December 2004 to January 2006. The mean age was from 27 to 77 (mean 57 ± 9.66) years old. Selected patients undergoing elective or emergency coronary angiography (CAG) examination, coronary angiography a coronary artery stenosis ≥ 50%, the diagnosis of coronary heart disease. Coronary angiography A coronary atherosclerotic patient with <50% vascular stenosis underwent intracoronary sonography. If a coronary artery had a stenosis of ≥ 75%, the coronary heart disease group was co-formed. A total of 62 cases, aged 34 to 77, mean (59.27 ± 9.65) years, 53 males and 9 females. Coronary angiography negative control group, a total of 30 cases, aged 27 to 72, mean (54.73 ± 9.68) years old, 21 males and 9 females. 16 cases of acute myocardial infarction in coronary heart disease group, 46 cases of angina pectoris as 2 subgroups of coronary heart disease. Coronary angiography results were based on the degree of coronary lesions were 1, 2, 3 lesions group as coronary heart disease in 3 subgroups, each patient coronary artery stenosis score. On the second day after admission, 9 ml of fasting venous blood and 9 ml of venous blood before emergency coronary angiography were divided into 3 parts and sent to biochemical and immunological compartments respectively. Enzyme immunoassay, double antibody sandwich ELISA and immunoturbidimetric assay Homocysteine, interleukin-6, and C-reactive protein levels were measured. SPSS10.0 software package for statistical analysis. Results Plasma HCY (P <0.02) and IL-6 in CHD group were significantly higher than those in control group (P <0.001). Serum CRP level was significantly higher than that in control group (P <0.002). There was no significant difference in HCY between acute myocardial infarction group and non-infarcted group in coronary heart disease group (P> 0.05), IL-6 was significantly higher than non-myocardial infarction group (P <0.01), CRP was significantly higher than non-infarcted group P <0.01). There was a correlation between HCY and coronary artery disease score (r = 0.277, P <0.05), CRP and coronary artery disease score (r = 0.2699, P <0.05) r = 0.343, P <0.001). Conclusions Homocysteine, interleukin-6 and C-reactive protein are predictors of the risk of coronary heart disease. The levels of IL-6 and CRP in patients with acute myocardial infarction are significantly higher than those in patients with acute myocardial infarction. The levels of HCY, IL-6, CRP and the severity of coronary artery disease Related.