急性冠脉综合征患者血清肿瘤坏死因子-α变化临床意义.docVIP

急性冠脉综合征患者血清肿瘤坏死因子-α变化临床意义 　【摘要】 目的 讨论肿瘤坏死因子(TNF-α)在急性冠脉综合征(ACS)患者血清中浓度变化及其意义。方法 选取40例ACS患者，其中不稳定型心绞痛(UAP)患者19例，急性心肌梗死(AMI)21例；60例非ACS患者中稳定型心绞痛(SAP)患者21例，陈旧性心肌梗死(OMI)19例，冠脉造影正常者20例，采用放射免疫法测定上述病例的血清TNF-α浓度。结果 (1)冠心病组(SAP组、UAP组、AMI组、OMI组)血清TNF-α浓度均显著高于正常对照组；ACS组(UAP组、AMI组)血清TNF-α水平显著高于非ACS组(SAP、OIM组)；AMI组血清TNF-α水平显著高于UAP组；SAP组与OMI组血清TNF-α水平差异无显著性；(2)SAP组与UAP组冠脉狭窄程度比较差异无显著性。结论 TNF-α参与冠心病的形成；并且在ACS的发病中起重要作用。检测血清TNF-α浓度将有助于诊断和预测ACS的发生、发展和预后。【关键词】 冠状动脉粥样硬化性心脏病 急性冠脉综合征 肿瘤坏死因子-α Clinical value of the changing TNF-α in the serum of different kings of ACS patients 【Abstract】 Objective Study the changing and meaning of TNF-α density in the seum of different kinds of ACS patients and the using value of TNF-α in clinical diagnosis and therapy.Methods Measure ment of TNF-α density in the serum of 40 ACS patients(among them，19unstable angina pectoris(UAP) patients，212 acute myocardial infarction(AMI) issues and 60 non-ACS patients(among them，22 stable angina pectoris)(SAP) patients，19 of OMI，19 whose coronary arteries show normal shadow);the TNF-α densities in the patient’s serum of group AMI are hgher notably than the ones of group UAP;as there are not notable differences of TNF-α densities between group SAP and group OMI2.There are not notable differences of the digrees of the coronary arterie’s narrowness between group SAP and group UAP.Results 1，TNF-α densities in the patientsserum of group SAP，group AMI and group OMI are higher notably than the one of control group;the TNF-α densities in the patients serum of group ACS(group UAP and group AMI) are higher than the ones of the group of non-ACS(group SAP and group OMI).Conclusion TNF-α participates in the forming of coronary atherosclerotic heart disease and plays an important role when ACS comes on.Measuing TNF-α density in the serum contributes to the diagnosing and predicting of ACS. 【Key words】 coronary atherosclerotic heart disease acute coronary syndrome tumor necrosis factor-α 冠心病发展中一个不可预测的原因是动脉粥样斑块(CAS)的不稳定性或破裂，诱发血