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目的研究老年急性冠状动脉综合征(acute coronary syndrome,ACS)合并糖尿病(diabetes mellitus,DM)患者血浆白细胞介素33(interleukin 33,IL-33)水平变化与ACS相关性。方法选取本院年龄≥65岁的住院患者188例行冠脉造影检查,男性105例,女性83例,平均年龄(70.8±4.4)岁。将其分为3组:ACS合并糖尿病者为糖尿病组(64例),ACS不合并糖尿病者为非糖尿病组(73例),冠脉造影正常且不合并糖尿病者为正常对照组(51例)。应用酶联免疫吸附法检测血浆IL-33浓度。采用Gensini评分对每支血管病变狭窄程度进行定量计算。结果血浆IL-33浓度在糖尿病组较非糖尿病组、非糖尿病组较对照组均升高,差异均有统计学意义(P<0.01)。糖尿病组多支血管病变者明显高于非糖尿病组,而单支血管病变者少于非糖尿病组,差异均有统计学意义(P<0.01),且糖尿病组多支血管病变者IL-33浓度明显高于单支病变者。糖尿病组和非糖尿病组患者Gensini评分值与血浆IL-33水平均呈正相关(r=0.663,P<0.01)。结论老年ACS患者血浆IL-33水平明显升高,且升高水平与冠脉病变程度有关,提示老年ACS患者的血管内皮存在炎症反应,合并糖尿病时加重。
Objective To study the association between the changes of plasma interleukin-33 (IL-33) and ACS in elderly patients with acute coronary syndrome (ACS) and diabetes mellitus (DM). Methods A total of 188 hospitalized patients ≥65 years of age undergoing coronary angiography were enrolled in this study. There were 105 males and 83 females, with an average age of 70.8 ± 4.4 years. They were divided into three groups: diabetic patients with diabetes mellitus (ACS) with diabetes mellitus (64 patients), ACS without diabetes mellitus (73 patients), normal coronary angiography without diabetes mellitus (n = 51) . Plasma IL-33 concentration was detected by enzyme-linked immunosorbent assay. The severity of each vascular lesion was quantified using the Gensini score. Results The concentration of plasma IL-33 in diabetic group was significantly higher than that in non-diabetic group and non-diabetic group, the differences were statistically significant (P <0.01). The number of multivessel disease in diabetic group was significantly higher than that in non-diabetic group, while the number of single vessel disease was less than that in non-diabetic group (P <0.01). The levels of IL-33 in multivessel disease group Obviously higher than single-vessel disease. There was a positive correlation between Gensini score and plasma IL-33 level in diabetic patients and non-diabetic patients (r = 0.663, P <0.01). Conclusions The level of plasma IL-33 in elderly patients with ACS is significantly higher than that in elderly patients with ACS, suggesting that there is an inflammatory reaction in the vascular endothelium of elderly patients with ACS, which aggravates with diabetes.