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目的:探讨血清胆固醇、炎症因子和冠心病斑块稳定性的相关关系。方法:2013年7月~2014年5月南京医科大学第一附属医院收治的冠心病患者107例,其中55例稳定性心绞痛(stable angina pectoris,SAP)患者为SAP组,52例急性冠状动脉综合征(acute coronary syndrome,ACS)患者为ACS组,并选取相同时期非冠心病患者96例为对照组。主要观察总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、总胆红素(total bilirubin,TBil)、超敏C反应蛋白(high sensitive C reactive protein,hs-CRP)、肿瘤坏死因子(tumor necrosis factor,TNF)-α、白介素(interleukin,IL)-6等炎症因子和斑块稳定性的相关关系。结果:ACS组TC和LDL-C分别为(6.38±1.17)mmol/L和(5.63±1.12)mmol/L,均高于SAP组[TC(4.51±1.06)mmol/L、LDL-C(4.42±1.05)mmol/L],且均高于对照组,差异具有统计学意义(P<0.05);ACS组TBil为(6.28±0.74)μmol/L,SAP组TBil为(9.96±1.02)μmol/L,均低于对照组,差异具有统计学意义(P<0.05)。ACS组Hs-CRP、IL-6和TNF-α分别为(19.06±3.72)mg/L、(57.35±4.14)pg/L和(38.11±2.64)pg/L,均高于SAP组[hs-CRP(11.31±2.15)mg/L、IL-6(29.60±3.08)pg/L和TNF-α(26.82±2.13)pg/L],且均高于对照组,差异具有统计学意义(P<0.05)。结论:冠心病患者血中TC、LDL-C、IL-6、TNF-α和Hs-CRP等明显增高,并与斑块稳定性呈正相关。
Objective: To investigate the relationship between serum cholesterol, inflammatory factors and plaque stability. Methods: From July 2013 to May 2014, 107 patients with coronary heart disease were admitted to the First Affiliated Hospital of Nanjing Medical University. 55 patients with stable angina pectoris (SAP) were SAP group, 52 patients with acute coronary syndrome Patients with acute coronary syndrome (ACS) were enrolled as ACS group and 96 non-CHD patients at the same period were selected as control group. To observe the effects of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), total bilirubin (TBil) and high sensitive C reactive protein hs-CRP), tumor necrosis factor (TNF) -α, interleukin (IL) -6 and other inflammatory factors and plaque stability. Results: The levels of TC and LDL-C in ACS group were (6.38 ± 1.17) mmol / L and (5.63 ± 1.12) mmol / L respectively, which were significantly higher than those in SAP group [TC 4.51 ± 1.06 mmol / L and LDL-C 4.42 ± 1.05) mmol / L], both of which were significantly higher than that of the control group (P <0.05). The TBil of the ACS group was (6.28 ± 0.74) μmol / L and that of the SAP group was (9.96 ± 1.02) μmol / L, both lower than the control group, the difference was statistically significant (P <0.05). The levels of Hs-CRP, IL-6 and TNF-α in ACS group were (19.06 ± 3.72) mg / L, (57.35 ± 4.14) pg / L and CRP (11.31 ± 2.15) mg / L, IL-6 (29.60 ± 3.08) pg / L and TNF-α (26.82 ± 2.13) pg / L] were significantly higher than those in the control group (P < 0.05). Conclusion: The levels of TC, LDL-C, IL-6, TNF-α and Hs-CRP in patients with coronary heart disease were significantly increased, and positively correlated with plaque stability.