急性冠脉综合征与血浆蛋白Z及炎症标志物的相关性研究

傅强+黄丹+王东旺+陈运和+陈宁南+唐斌

[摘要] 目的 探讨急性冠脉综合征与血浆蛋白Z（PZ）及炎症标志物的相关性与临床意义。 方法 筛选 100例急性冠脉综合征（ACS）患者，其中急性心肌梗死（AMI）组55 例，不稳定型心绞痛（UAP）组45 例；50例正常对照者。按试剂盒方法测定PZ和炎症标志物水平。 结果 ACS组血清PZ、PPAR-α显著低于正常对照组（P<0.01），而hs-CRP、TNF-α、IL-6、IL-8水平显著高于正常对照组（P<0.01）；AMI组PZ、PPAR-α水平低于UAP 组，hs-CRP、IL-6水平高于UAP 组，但差异无统计学意义（P>0.05）。AMI组TNF-α、IL-8水平明显高于UAP 组（P<0.05）。PZ、PPAR-α的表达水平与hs-CRP、TNF-α、IL-6、IL-8呈负相关（r=-0.445、-0.398、-0.534、-0.321；-0.365、-0.511、-0.423、-0.396，P<0.01）。结论 急性冠脉综合征患者血浆PZ水平明显下降，提示PZ缺乏可能是急性冠脉综合征存在的一个危险因素。PPAR-α 表达明显下调，与明显上升的hs-CRP、TNF-α、IL-6、IL-8呈负相关，提示PPAR-α可能通过抗炎反应，hs-CRP、TNF-α、IL-6、IL-8等可能参与促炎反应参与急性冠脉综合征发病过程，并与斑块的不稳定状态有关。

[关键词] 急性冠脉综合征；血浆蛋白Z；炎症

[中图分类号] R541.4 [文献标识码] B [文章编号] 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.