傅強(qiáng)+黃丹+王東旺+陳運(yùn)和+陳寧南+唐斌

[摘要] 目的 探討急性冠脈綜合征與血漿蛋白Z（PZ）及炎癥標(biāo)志物的相關(guān)性與臨床意義。 方法 篩選 100例急性冠脈綜合征（ACS）患者，其中急性心肌梗死（AMI）組55 例，不穩(wěn)定型心絞痛（UAP）組45 例；50例正常對(duì)照者。按試劑盒方法測(cè)定PZ和炎癥標(biāo)志物水平。 結(jié)果 ACS組血清PZ、PPAR-α顯著低于正常對(duì)照組（P<0.01），而hs-CRP、TNF-α、IL-6、IL-8水平顯著高于正常對(duì)照組（P<0.01）；AMI組PZ、PPAR-α水平低于UAP 組，hs-CRP、IL-6水平高于UAP 組，但差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）。AMI組TNF-α、IL-8水平明顯高于UAP 組（P<0.05）。PZ、PPAR-α的表達(dá)水平與hs-CRP、TNF-α、IL-6、IL-8呈負(fù)相關(guān)（r=-0.445、-0.398、-0.534、-0.321；-0.365、-0.511、-0.423、-0.396，P<0.01）。結(jié)論 急性冠脈綜合征患者血漿PZ水平明顯下降，提示PZ缺乏可能是急性冠脈綜合征存在的一個(gè)危險(xiǎn)因素。PPAR-α 表達(dá)明顯下調(diào)，與明顯上升的hs-CRP、TNF-α、IL-6、IL-8呈負(fù)相關(guān)，提示PPAR-α可能通過(guò)抗炎反應(yīng)，hs-CRP、TNF-α、IL-6、IL-8等可能參與促炎反應(yīng)參與急性冠脈綜合征發(fā)病過(guò)程，并與斑塊的不穩(wěn)定狀態(tài)有關(guān)。

[關(guān)鍵詞] 急性冠脈綜合征；血漿蛋白Z；炎癥

[中圖分類(lèi)號(hào)] R541.4 [文獻(xiàn)標(biāo)識(shí)碼] B [文章編號(hào)] 1673-9701（2014）32-0019-03

The relation study of acute coronary syndrome， plasma protein Z and inflammatory markers

FU Qiang1 HUANG Dan2 WANG Dongwang1 CHEN Yunhe1 CHEN Ningnan1 TANG Bin1

1.Emergency Department， the Peoples Hospital in Jiangxi Province， Nanchang 330006， China； 2.Anaesthesia Department， the Second Hospital Affiliated to Nanchang University， Nanchang 330006， China

[Abstract] Objective To study the relation and clinical significance between inflammatory markers， plasma protein Z levels and acute coronary syndrome（ACS）. Methods One hundred acute coronary syndrome （ACS） patients， which was comprised of 55 patients with acute myocardial infarction （AMI） and 45 patients with unstable angina pectoris （UAP）， and 50 normal control cases were recruited for this study. The levels of PZ and inflammatory markers were measured according to the kit method. Results The PZ， PPAR-α levels of ACS group were significantly lower than that of the control group （P<0.01）， while the hs-CRP， TNF-α， IL-6， IL-8 levels were significantly higher （P<0.01）. The PZ， PPAR-α levels of AMI group were lower than that of the UAP group， while the hs-CRP， IL-6 levels were higher， but without significant difference（P>0.05）， the TNF-α， IL-8 levels were significantly higher than that of the UAP group （P<0.05）. There were significantly inversely correlation between the expression levels of PZ， PPAR-α and hs-CRP， TNF-α， IL-6， IL-8 （r=-0.445， -0.398， -0.534， -0.321； -0.365， -0.511， -0.423， -0.396， P<0.01）. Conclusion Plasma levels of PZ significantly decreased in patients with ACS， which suggested that PZ deficiency is likely to be a risk factor. PPAR-α expression decreased， which is negative correlated with the expression of hs-CRP， TNF-α， IL-6， IL-8， suggest that it may have anti-inflammatory in the process of ACS， and hs-CRP， TNF-α， IL-6， IL-8 may participate in proinflammatory reactions involved in the onset of ACS process， and they are associated with unstable state of plaque.