作　　者： (秦峰）; (丁志祥）; (李小龙）; (孙毅）; (虞丽娟）; (季海刚）; (张琪）;

机构地区： 南京中医药大学附属常州市中医医院检验科,江苏常州213003

出　　处： 《临床检验杂志》 2017年第8期609-611,共3页

摘　　要： 目的探讨IL-27在急性冠脉综合征(ACS)中的临床应用价值。方法入选208例ACS患者,其中ST段抬高的心肌梗死(STEMI)76例、非ST段抬高的心肌梗死(NSTEMI)58例和不稳定心绞痛(UAP)74例;根据冠脉病变数分为单支、双支和三支病变组;以同期62例胸痛综合征(CPS)患者作为对照组。用酶联免疫吸附试验(ELISA)检测各组血浆IL-27的表达水平并进行统计学分析。结果与对照组100.66(68.98,228.86)pg/m L比较,STEMI组、NSTEMI组、UAP组血浆IL-27表达水平[分别为308.64(245.17,359.26)、256.88(181.52,332.51)、218.12(165.33,312.46)pg/m L]均明显升高(P均<0.01);组间两两比较结果表明,STEMI组血浆IL-27浓度明显高于NSTEMI组和UAP组(P均<0.05);,在TnI阴性的ACS患者中,IL-27阳性率为54.24%(32/59);IL-27在胸痛患者中预测ACS发生的敏感性和特异性分别为80.29%和58.06%。冠脉三支病变组IL-27表达水平明显高于单支病变组(P<0.05)。结论 IL-27在ACS患者外周血中表达明显升高,可能参与了ACS的发病机制。IL-27对TnI阴性的ACS患者以及ACS病情判断具有一定临床价值。 Objective To investigate the application value of interleukin-27（ IL-27） in the patients with acute coronary syndrome（ ACS）. Methods A total of 208 ACS patients were enrolled in the study,including 76 acute myocardial infarction（ AMI） patients with ST elevation（ STEMI）,58 AMI patients with non-ST elevation（ NSTEMI） and 74 unstable angina pectoris（ UAP） patients.These patients were divided into single-vessel lesions,double-vessel lesions and three-vessel lesions groups,and 62 patients with chest pain syndrome（ CPS） were selected as a control group. The plasma IL-27 levels of all patients were determined by enzyme linked immunosorbent assay（ ELISA） and analyzed. Results The levels of plasma IL-27（ median[P25,P75]） in STEMI（ 308. 64[245. 17,359. 26] pg/m L）,NSTEMI（ 256. 88[181. 52,332. 51] pg/m L） and UAP（ 218. 12[165. 33,312. 46] pg/m L） patients were significantly higher than that in CPS patients（ 100. 66[68. 98,228. 86] pg/m L,P〈0. 01）. The levels of plasma IL-27 in STEMI patients were significantly higher than that in NSTEMI and UAP patients（ P〈0. 05）. The positive rate of IL-27 in ACS patients with negative Tn I was 54. 24%（ 32/59）. The sensitivity and specificity of IL-27 in predicting ACS from chest pain patients were 80. 29%and 58. 06%,respectively. The levels of plasma IL-27 in the patients with three-vessel lesions were significantly higher than that with single-vessel lesions（ P〈0. 05）. Conclusion Plasma IL-27 levels in ACS patients increase obviously,which may be involved in the pathogenesis of ACS. IL-27 may be helpful for the diagnosis of ACS patients with negative Tn I and the prediction of ACS state.

关 键 词： 急性冠脉综合征 肌钙蛋白