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目的:研究冠心病患者血清中可溶性不规则趋化因子(sFKN)和肿瘤坏死因子α(TNF-α)的变化及贝那普利(洛汀新)对二者表达的影响。方法:本研究纳入对照组15例、稳定型心绞痛(SA)组25例、急性冠状动脉综合征(ACS)组48例;对ACS组再进行分组,服用贝那普利6个月以上者28例为贝那普利亚组,近6个月内未应用任何血管紧张素转化酶抑制剂及血管紧张素Ⅱ受体拮抗剂者20例为非贝那普利亚组;用酶联免疫吸附法测定患者血清中sFKN和TNF-α的水平,比较各组之间sFKN、TNF-α水平差异,sFKN、TNF-α和冠状动脉造影Gensini积分之间的相关性。结果:与对照组相比,血清sFKN在SA组差异无统计学意义,在ACS组显著升高(P<0.01);TNF-α在SA组、ACS组均明显升高,差异有统计学意义(P<0.01),TNF-α在SA组与ACS组之间差异亦有统计学意义(P<0.01),ACS组高于SA组。贝那普利组血清sFKN和TNF-α浓度低于非贝那普利组,差异有统计学意义(P<0.05)。Pearson直线相关分析显示:血清sFKN和TNF-α浓度之间有相关性(r=0.7),sFKN、TNF-α与Gensini积分无相关性。结论:血清sFKN和TNF-α是冠心病发病过程中的重要炎症递质,贝那普利可能存在抗炎作用。
Objective: To study the changes of soluble sFKN and TNF-α in sera of patients with coronary heart disease (CHD) and the effect of benazepril (Lotensin) on them. Methods: Fifteen patients in the control group, 25 patients with stable angina pectoris (SA) and 48 patients with acute coronary syndrome (ACS) were enrolled in this study. Patients in ACS group were further divided into groups, and those who took benazepril for more than 6 months In the case of benazepril group, 20 cases were non-benazepril group without angiotensin converting enzyme inhibitor and angiotensin II receptor antagonist in the recent 6 months. Methods The levels of sFKN and TNF-α in sera of patients were determined. The correlations of sFKN, TNF-α, sFKN, TNF-α and coronary angiography Gensini scores were compared between groups. Results: Compared with the control group, the level of sFKN in SA group was not significantly different (P <0.01), while the levels of TNF-α in SA group and ACS group were significantly increased (P <0.01). The difference of TNF-α between SA group and ACS group was also statistically significant (P <0.01). The level of TNF-α in ACS group was higher than that in SA group. The concentrations of serum sFKN and TNF-α in benazepril group were significantly lower than those in non-benazepril group (P <0.05). Pearson linear correlation analysis showed that serum sFKN and TNF-α concentrations were correlated (r = 0.7), sFKN and TNF-α had no correlation with Gensini scores. Conclusion: Serum sFKN and TNF-α are important inflammatory mediators in the pathogenesis of coronary heart disease. Berenipril may have anti-inflammatory effects.