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目的观察老年急性冠脉综合征(ACS)血浆白介素-18(IL-18)、基质金属蛋白酶-1(MMP-1)、高敏C反应蛋白(hs-CRP)改变及临床意义。方法老年ACS75例(ACS组)、稳定型心绞痛(SA)和陈旧心肌梗死(OM I)60例(非ACS组)、冠脉正常者55例(对照组),ELISA法检测血浆IL-18和MMP-1,免疫透射比浊法检测血浆hs-CRP,所有患者行冠状动脉造影、超声心动图检查。结果ACS组血浆炎性因子IL-18、MMP-1和hs-CRP高于非ACS组和对照组(P<0.05);ACS组二尖瓣血流频谱E/A比值<1和左室射血分数(LVEF)<50%发生率高于非ACS组和对照组(P<0.05)。结论①IL-18、hs-CRP是老年ACS的独立危险因素;②IL-18、MMP-1和hs-CRP升高并心脏功能异常的老年冠心病的危险性增高,冠脉粥样斑块极不稳定。
Objective To observe the changes and clinical significance of plasma interleukin-18 (IL-18), matrix metalloproteinase-1 (MMP-1) and high sensitivity C-reactive protein (hs-CRP) in elderly patients with acute coronary syndrome (ACS) Methods Sixty elderly ACS patients, stable angina pectoris (SA) and old myocardial infarction (OM I) 60 patients (non-ACS group) and 55 normal coronary arteries (control group) were enrolled in this study. Plasma IL-18 and MMP-1 and hs-CRP were detected by immunoturbidimetry. All patients underwent coronary angiography and echocardiography. Results The plasma levels of inflammatory cytokines IL-18, MMP-1 and hs-CRP in ACS group were significantly higher than those in non-ACS group and control group (P <0.05) The incidence of LVEF <50% was higher than that of non-ACS group and control group (P <0.05). Conclusion ①IL-18 and hs-CRP are independent risk factors for senile ACS. ②The risk of coronary heart disease in elderly patients with elevated levels of IL-18, MMP-1 and hs-CRP and cardiac dysfunction is high, stable.