目的 通过观察外周血白细胞介素6受体(IL-6R)、金属肽酶含血小板反应蛋白基元1(ADAMTS-1)、超敏C反应蛋白(hs CRP)水平与冠心病患者Gensini评分、斑块Ambrose分类的关系,探讨IL-6R、ADAMTS 1及hs CRP与不稳定型斑块的相关性. 方法 连续选取在我院行冠状动脉造影检查患者328例,其中冠心病患者(冠心病组)272例中急性心肌梗死105例、不稳定型心绞痛126例、稳定型心绞痛41例;冠状动脉造影无狭窄患者56例为对照组.所有患者检测外周血清IL-6R、ADAMTS-1及hs-CRP水平.冠心病患者对冠状动脉造影结果行Gensini评分,斑块的性质采用Ambrose分类评价. 结果 心肌梗死组、不稳定型心绞痛组血清IL-6R、ADAMTS-1水平高于稳定型心绞痛组、对照组(均P<0.05);心肌梗死组hs CRP水平高于不稳定型心绞痛组、稳定型心绞痛组、对照组(均P<0,05);Ambrose分类复杂病变患者(170例)IL 6R、ADAMTS 1、hs-CRP水平高于简单病变(102例)、对照组(均P< 0.05),简单病变患者ADAMTS-1水平高于对照组(P<0.05);冠心病组IL-6R水平与ADAMTS-1水平呈正相关(r=0.70,P<0.05),IL-6R、ADAMTS-1、hs-CRP水平与Gensini评分无相关性(均P>0.05). 结论 IL-6R、ADAMTS-1及hs-CRP可作为判断斑块的稳定性指标,与冠状动脉的狭窄程度无关.
Objective To investigate the relationships of peripheral blood levels of interleukin 6 receptor (IL-6R),a disintegrin and metalloprotease with thrombospondin type 1 motifs (ADAMTS-1) and high sensitive C reactive protein (hs CRP) with Gensini score and Ambrose classification in patients with coronary heart disease,and to investigate the correlations of IL-6R,ADAMTS-1 and hsCRP levels with unstable coronary atherosclerotic plaques.Methods 328 patients undergoing coronary angiography were admitted,and 272 patients were diagnosed as coronary heart disease including 105 cases with acute myocardial infarction (AMI),126 cases with unstable angina peetoris (UA) and 41 cases with stable angina pectoris (SA).The 56 cases with no coronary artery stenosis were selected as control group.We detected the levels of IL-6R,ADAMTS 1 and hs-CRP in all patients,and then evaluated their Gensini scores by coronary angiography,and appraised the character of the plaque by Ambrose classification.Results The serum levels of IL 6R and ADAMTS-1 were higher in AMI and UA groups than in SA and normal control groups (all P<0.05).The level of hsCRP was higher in AMI group than in UA,SA and control groups (all P<0.05).The levels of IL-6R,ADAMTS 1 and hs-CRP were higher in complex lesion group evaluated by Ambrose classification than in simple lesion group and normal control group (all P<0.05).ADAMTS-1 level was higher in simple lesion group than in normal control group (P<0.05).The level of IL 6R was positively correlated with ADAMTS-1 levels (r=0.70,P<0.05),while the serum IL-6R,ADAMTS-1 and hsCRP levels had no relationship with Gensini score in patients with coronary heart disease (all P> 0.05).Conclusions The IL-6R,ADAMTS-1 and hs-CRP levels can be the indexes for evaluating the plaque stability in patients with coronary heart disease,but have no relationships with the severity of coronary artery stenosis.