The Hs - Crp Serum In Patients With Acute Coronary Syndromes And Il - 10 Level Change And Clinical Significance

Background:Acute coronary syndrome (ACS) is a group of clinical syndrome that is caused by acute myocardial ischemia, the state of this illness is extremely dangerous. In recent years, the incidence of this disease has rose, and the trend become younger than before. The study found that Although the clinical symptoms each different, but the base of the pathological anatomy is all by coronary atherosclerotic plaque from stable to stability, then plaque ruptured and thrombosis lead to coronary artery completely or not totally occluded. Atherosclerosis (AS) is the most common and most important atherosclerosis vascular disease. For many years, People have made extensive and in-depth research for coronary atherosclerosis, it showed that AS was caused by various factors and the factors worked in different link, among this, Smoking, dyslipidemia, high blood pressure, diabetes and abnormal glucose tolerance is the main risk factors. In the past, it had some different theories from different point of view to expound the pathogenesis of AS. Including lipid infiltration theory, thrombosis theory, smooth muscle cells cloned theory, etc. But, much of the recent research indicate that inflammation play an important role in the process of atherosclerosis (AS) occurrence, development and evolution. People Try to detection inflammation markers for predicting cardiovascular events.The current research for inflammation index mainly includes high-sensitive C-reactive protein(hs-CRP), serum amyloid A(SAP), interleukin4(IL-4), A interleukin6(IL-6), interleukin10(IL-10), pregnancy-associated plasma Protein A(PAPP-A), matrix metalloproteinase(MMP), etc. People come to realize AS hemal wall not only exist in promoting the inflammatory reaction, and anti-inflammatory reactions are also involved. Hs-CRP is a kind of sensitive index to reflect the various infections and noninfectious inflammation for our body. So, as the sensitive marker, hs-CRP play an important role in predicting the level of atherosclerosis inflammatory reaction. IL-10is the most extensive anti-inflammatory factor by the research, it can inhibit plaques and steady plaques, and this effect is paid much more attention day by day. Serum IL-10level reflects its anti-inflammatory effect, at the same time, people also make a positive exploration to its mechanism of anti-atherosclerosis effect. Promote inflammation response and anti-inflammatory reaction all participated in the development of atherosclerosis, the end of the atherosclerotic plaque may be concerned with the imbalance of inflammatory reaction and anti-inflammatory reaction. So the research of hs-CRP and IL-10to the influence of the atherosclerotic plaque stability has important clinical significance.Objective:Acute coronary syndrome defined as unstable angina pectoris(UAP), non-ST-elevation myocardial infarction(NSTEMI) and ST-elevation myocardial infarction(STEMI), its stability of plaques relate to inflammatory reaction. To determinate serum high-sensitivity C-reactive protein (hs-CRP) and interleukin-10(IL-10) levels in patients with acute coronary syndromes(ACS) and explore their relation with plaques stability.Methods:29patients with ACS, including16patients with acute myocardial infarction(AMI),13patients with unstable angina pectoris(UAP).The study also included20patients with stable angina pectoris (SAP) and20cases of control subjects. All selected patients underwent selective coronary angiography (CAG). According to the severity of coronary artery stenosis, all selected patients divided into four groups:control subjects, single-artery lesions, double-artery lesions and multi-artery lesions; They both fasting blood collection, the serum hs-CRP and IL-10levels were measured by double antibody enzyme linked immunosorbent assay (ELISA)Results:ACS patients exhibited higher serum levels of hs-CRP and IL-10as compared with those of SAP patients and controls (P<0.05), SAP group serum hs-CRP and IL-10levels were higher than that of the control group, but no significant difference compared (P>0.05); The ratio of serum hs-CRP/IL-10in ACS group of patients was higher than SAP group and control group (P<0.05), The ratio of serum hs-CRP/IL-10in SAP group compared with control group was no significant differences (P>0.05); There was positive correlation between serum hs-CRP and IL-10levels in patients with ACS (r=0.73, P<0.05). hs-CRP gradually increased in patients with single-artery lesions group, double-artery lesions group and multi-artery lesions group (P<0.05),but there was no significant differences between single-artery lesions group and the control group (P>0.05); The levels of IL-10and hs-CRP/IL-10were higher in multi-artery lesions group than single-artery lesions group or control group (P<0.05), but there was no significant differences between multi-artery lesions group and double-artery lesions group (P>0.05);The double-artery lesions group was higher than single-artery lesions group or control group (P<0.05), there was no significant differences between single-artery lesions group and control group (P>0.05).Conclusions:The serum levels of hs-CRP and IL-10raise, the ratio of hs-CRP/IL-10increase in ACS patients, which showed that it have some inflammation in ACS patients, and this inflammation participate in atherosclerotic plaque formation, and Inflammation imbalance may have some relation with the instability of plaques in ACS patients. The serum levels of hs-CRP and IL-10may be contact with multi-vessel stenosis, they can be used to predict the severity of coronary disease.