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目的 :探讨炎症标记物与冠心病的关系及临床意义。方法 :选择健康体检者 (正常对照组 ) 30例、稳定型心绞痛 (SAP组 )患者 2 0例、不稳定型心绞痛 (UAP)患者 2 5例和急性心肌梗死 (AMI)患者 30例 ,分别测定血清中C 反应蛋白 (CRP)、白细胞介素 6 (IL 6 )和肿瘤坏死因子 α(TNF α)的浓度。结果 :①SAP、UAP、AMI与正常对照组比较 ,血清中CRP、IL 6、TNF α均显著增高 ,差异均具有统计学意义 (均P <0 .0 1) ;②UAP与SAP比较 ,血清中CRP、TNF α均显著增高 (P <0 .0 1) ,但与IL 6比较差异无统计学意义 ;③AMI与SAP比较 ,血清中CRP、IL 6、TNF α均显著增高 ,差异均具有统计学意义 (P <0 .0 1) ;④AMI与UAP比较 ,血清中CRP、IL 6、TNF α均显著增高 ,差异均具有统计学意义 (P <0 .0 5 ) ;⑤血清中CRP、IL 6、TNF α在AMI发病的 72h以内有明显动态变化。结论 :炎症参与了冠心病的发病过程 ,血清中炎症因子水平的高低与冠心病的严重程度有关 ,AMI时炎症因子的动态演变可以作为病情稳定性的指标 ,对判断病情和预后具有临床价值。
Objective: To investigate the relationship between inflammatory markers and coronary heart disease and its clinical significance. Methods: Thirty healthy subjects (20 normal controls), 20 patients with stable angina pectoris (SAP), 25 patients with unstable angina pectoris (UAP) and 30 patients with acute myocardial infarction (AMI) were enrolled in this study. Serum levels of C-reactive protein (CRP), interleukin 6 (IL 6), and tumor necrosis factor α (TNFα). Results: ① Compared with normal control group, the levels of serum CRP, IL-6 and TNF-α in SAP, UAP and AMI were significantly increased (all P <0.01); ②The serum levels of CRP , TNFα were significantly higher (P <0.01), but with no significant difference compared with IL 6; ③AMI compared with SAP, serum CRP, IL 6, TNFα were significantly increased, the difference was statistically significant (P <0.01). (4) Compared with UAP, the levels of CRP, IL-6 and TNF-alpha in serum were significantly increased (all P <0.05) TNFα in the onset of AMI within 72h obvious dynamic changes. Conclusion: Inflammation is involved in the pathogenesis of coronary heart disease. The level of inflammatory cytokines in serum is related to the severity of coronary heart disease. The dynamic evolution of inflammatory cytokines in AMI can be used as an indicator of disease stability and has clinical value in judging the disease and prognosis.