Study On Relationship Between Serum Inflammatory Cytokines And Acute Coronary Syndrome

Objective:we measured and compared serum concentration of TNF-a,hs-CRP, MMP-9 and M-CSF in patients with different clinical kinds of CHD to investigate the effect of inflammation and these cytokines on the genesis and development of CHD.Methods:35 patients with acute myocardial infarction (AMI),40 patients with unstable angina pectoris (UAP),41 patients with stable angina pectoris (SAP) and 36 controls were studied. We measured the serum concentration of TNF-α, hs-CRP, MMP-9 and M-CSF by ELISA, and compared the results of different groups with each other. All selected objects are diagnosed by coronary angiography, and analyzed by application of SPSS 16.0.Results:1. There was no significant difference in gender,age,hypertension,diaetes mellitus and serum concentration of lipid (LDL,TC,TG) among the three groups patients (P> 0.05),expect in smoking and HDL (P<0.01).2. Compared with SAP group and control group,the serum concentration of M-CSF,TNF-a and MMP-9 in ACS group were significantly increased (P<0.01).3. Compared with control group,the serum concentration of hs-CRP in AMI group was higher (P<0.01).4. Compared with UAP group, the serum concentration of M-CSF in AMI group was higher(P< 0.05).But there was no significant difference in the serum concentration of hs-CRP,MMP-9 and TNF-a between AMI group and UAP group (P >0.05).5. There was also no significant difference in the serum concentration of these four cytokines between SAP group and control group (P>0.05).6. To CHD as the dependent variable, age, sex, history of hypertension, diabetes history,smoking history,TC, TG, HDL, LDL, MMP-9, hs-CRP, TNF-αand M-CSF as a variable to do Logistic regression analysis showed that age, smoking, MMP-9 and M-CSF and the pathogenesis of CHD,regression coefficients were 0.081,1.953,0.073, 0.065.7. There is a positive correlation between MMP-9, hs-CRP, TNF-a and M-CSF (r values were 0.405,0.422,0.485, P<0.01), hs-CRP and TNF-α, M-CSF exist a positive correlation(r values were 0.664,0.529, P<0.01), TNF-a and M-CSF exist a positive correlation (r=0.718, P<0.01).Conclusion:1.CHD is closely associated with the inflammatory response, and it plays an important role in the development of all aspects of AS.Inflammatory response has became the clinical detection and intervention an important part of dealing with ACS.2.The serum TNF-a, hs-CRP, MMP-9 and M-CSF play an important role in promoting the formation of AS and unstable. There is extremely important clinical value to assess the risk of cardiovascular events, Confirm the extent of CHD and predict future CHD disease prognosis by the clinical assessment of the inflammatory cytokines.3.By this study, there exist positive correlation among four inflammatory cytokines.They cooperate and induce each other during the development of CHD,they exist the complex networking, and promote the formation of AS and the progress of CHD.4. There are multiple risk factors during the occurrence of CHD, by this study on risk factors for CHD regression analysis we learn we must control the risk factors for the prevention of the occurrence of significant CHD.