血浆白介素18/白介素10比值与稳定型心绞痛患者发生急性冠脉综合征的关系

Interleukin-18/interleukin-10 ratio and development of acute coronary syndrome in stable angina pectoris patients

摘要:

目的 探讨白介素（IL）-18/IL-10比值与稳定型心绞痛患者发生急性冠脉综合征的关系, 探索防治急性冠脉综合征发生的新途径。方法 采用酶联免疫吸附法检测215例稳定型心绞痛患者IL-18和IL-10的水平变化, 并对所有患者进行24个月随访, 根据随访的结果将患者分为发生急性冠脉综合征组（A组, 38例）及未发生急性冠脉综合征组（B组, 173例）。结果 A组患者血浆IL-18水平及IL-18/IL-10比值显著高于B组[（229±77）vs（166±50）ng/L, （2.4±0.7）vs（1.6±0.6）, P＜0.01], A组患者血浆IL-10水平低于B组[（101±37）vs（115±38）ng/L, P＜0.05]; 高血浆IL-18/IL-10比值使稳定型心绞痛患者发生急性冠脉综合征的优势比值增加3.935倍（P＜0.01）。结论 稳定型心绞痛患者血浆IL-18和IL-10水平与急性冠脉综合征的发生密切相关; IL-18/IL-10比值增高对稳定型心绞痛患者发生急性冠脉综合征有一定预测价值, 提示机体炎症活动增强是促进急性冠脉综合征发生的重要因素, 抗炎治疗可能是防治急性冠脉综合征的途径之一。

Abstract:

Objective To investigate the relationship between interleukin-18(IL-18)/interleukin-10(IL-10) ratio and the development of acute coronary syndrome(ACS) in stable angina pectoris(SAP) patients so as to provide new ideas for prevention of ACS. Methods The plasma IL-18 and IL-10 levels were measured by enzyme-linked immunosorbent assay in 215 SAP patients. The patients were divided into 2 groups: ACS group(group A, n=38) and non-ACS group(group B, n=173) according to the results of 24-month follow-up. Results Plasma IL-18 level and IL-18/IL-10 ratio were higher in group A than in group B[(229±77) vs (166±50) ng/L, (2.4±0.7) vs (1.6±0.6) respectively, P＜0.01]. Plasma IL-10 level was lower in group A than in group B[(101±37) vs (115±38)ng/L, P＜0.05]. Logistic regression analysis showed that high IL-18/IL-10 ratio increased the relative risk of ACS in SAP patients by 3.935 times(P＜0.01). Conclusion The plasma IL-18 and IL-10 levels are closely related to the development of ACS in SAP patients. Higher IL-18/IL-10 ratio is predictive of ACS development in SAP patients, which suggests that inflammation is an important enhancing factor for developing ACS, and anti-inflammatory treatment might be a new method for preventing ACS.