目的：探讨急性冠状动脉综合征患者血浆白细胞介素（IL）‐35、几丁质酶‐3样蛋白1（YKL‐40）和脂联素水平变化及其临床意义。方法入选冠心病患者117例，分为急性心肌梗死（AMI）组40例、不稳定性心绞痛（UAP）组40例和稳定性心绞痛（SAP）组37例。另选同期有胸痛症状冠状动脉造影正常的患者30例为对照组。再将117例冠心病患者按Gensini积分分为轻度病变组（＜26分）44例、中度病变组（26～54分）40例和重度病变组（＞54分）33例。分别检测血浆高敏C反应蛋白（hs‐CRP）、IL‐35、YKL‐40和脂联素水平。结果与对照组比较，SAP组、UAP组和AMI组hs‐CRP和YKL‐40明显升高，IL‐35和脂联素明显降低（P＜0．05，P＜0．01）；脂联素与Gensini积分呈负相关（r＝－0．844，P＜0．01），IL‐35与Gensini不相关（r＝－0．033，P＝0．726），YKL‐40与Gensini积分呈正相关（r＝0．814，P＜0．01）。结论冠心病患者血浆IL‐35、脂联素明显降低，而YKL‐40明显升高，在一定程度上反应了冠心病患者的病情及病变严重程度，对冠心病的诊断及预后可能有潜在的临床应用价值。%Objective To study the change of IL‐35 ,YKL‐40 and APN levels in patients with acute coronary syndrome and its clinical significance .Methods One hundred and seventeen coronary heart disease (CHD)patients were divided into acute myocardial infarction (AMI)group (n=40) , unstable angina pectoris (UAP) group (n= 40) ,stable angina pectoris (SAP) group (n= 37) . Thirty patients with chest pain and normal angiography served as a control group .The 117 CHD patients were further divided into mild CHD group with its Gensini score<26 (n=44) ,moderate CHD group with its Gensini score being 26 -54 (n=40)and severe CHD group with its Gensini score>54 (n= 33) .Theier serum IL‐35 ,YKL‐40 and APN levels were measured by ELISA . Results The serum IL‐35 and YKL‐40 levels were significantly higher whereas the serum IL‐35 and APN levels were significantly lower in SAP group ,UAP group and AMI group than in con‐trol group (P<0 .05 ,P<0 .01) .The serum APN level was negatively related with the Gensini score (r= -0 .844 ,P< 0 .01) ,the serum IL‐35 level was not related with the Gensini score (r= -0 .033 ,P= 0 .726) ,and the serum YKL‐40 level was positively related with the Gensini score (r=0 .814 ,P<0 .01) .Conclusion The significantly lower serum IL‐35 and APN levels and significantly higher serum YKL‐40 level indicate the severity of CHD at a certain extent ,and can thus be used as predictors for the diagnosis and prognosis of CHD .
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