不良情绪对冠心病患者炎性反应及内皮功能的影响

摘要

目的 探讨不良情绪对冠心病患者炎性反应及内皮功能的影响.方法 收集2016年4月～2017年4月石家庄市第一医院收治的92例冠心病合并不良情绪患者为病例组,根据Zung焦虑/抑郁自评量表评分(SAS/SDS)将其分为冠心病合并焦虑情绪患者(焦虑组,39例)、冠心病合并抑郁情绪患者(抑郁组,53例),并于同期随机选取50例无不良情绪冠心病患者为对照组.采用酶联免疫吸附法测定各组血清炎性反应水平和血清内皮功能相关因子.结果 焦虑组、抑郁组血清白细胞介素(IL)-1β、IL-6、IL-6R、IL-18、肿瘤坏死因子α(TNF-α)、基质金属蛋白酶9(MMP-9)水平均高于对照组,差异有统计学意义(P＜0.05).焦虑组、抑郁组血清血管内皮素1(ET-1)、血栓素B2(TXB2)水平高于对照组,一氧化氮(NO)、6-酮-前列腺素F1α(6-keto-PGF1α)水平低于对照组,差异均有统计学意义(P＜0.05).经Pearson积矩相关分析,SAS、SDS评分与IL-1β、IL-6、IL-6R、IL-18、TNF-α、MMP-9、ET-1、TXB2呈正相关(P＜0.05),与NO、6-keto-PGF1α呈负相关(P＜0.05).结论 冠心病合并不良情绪患者存在不同程度的炎性反应激活以及内皮功能损伤,不良情绪通过加重炎性反应以及内皮功能损伤而促进冠心病病情的进展.%Objective To explore the effect of adverse emotion on inflammatory reaction and endothelial function in patients with coronary heart disease.Methods Ninety-two patients with coronary heart disease combined with adverse emotion in Shijiazhuang First Hospital from April 2016 to April 2017 were collected as case group,in which coronary heart disease with anxiety patients (anxiety group) had 39 cases and coronary heart disease with depression patients (depression group) had 53 cases according to the scores of Zung self-rating anxiety/depression scale (SAS/SDS).At the same time,50 patients with coronary heart disease without adverse emotion were randomly selected as control group.The serum inflammation factors and endothelium function related factors were detected by the enzyme-linked immunosorbent assay.Results The levels of serum interleukin (IL)-1β,IL-6,IL-6R,IL-18,tumor necrosis factor-α (TNF-α),matrix metalloproteinase-9 (MMP-9) in anxiety group,depression group were higher than those in control group (P ＜ 0.05).The levels of serum endothelin 1 (ET-1),thromboxane B2 (TXB2) in anxiety group,depression group were higher than those in control group,and the levels of NO,6-keto-prostaglandin F1α (6-keto-PGF1α) in anxiety group,depression group were lower than those in control group,the differences were statistically significant (P ＜ 0.05).The Pearson product moment correlation analysis showed that the scores of SAS,SDS were positively associated with IL-1β,IL-6,IL-6R,IL-18,TNF-α,MMP-9,ET-1,TXB2,which were negatively associated with NO,6-keto-PGF1α (P ＜ 0.05).Conclusion The patients with coronary heart disease with adverse emotion have inflammatory response activation and endothelial dysfunction with different degrees.Adverse emotion can promote the progress of coronary heart disease by increasing the inflammatory response and endothelial dysfunction.