The Research Of Inflammatory Markers In The Mechanism Of Coronary Heart Disease

BackgroundCoronary heart disease (CHD) has been the first critical disease of human being around world. Several risk factors for CHD have been well documented, including hyperlipidemia,hypertension, smoking, diabetes, a positively family history, obesity and inactivity. However, these factors explain only part of attributable cardiovascular disease. It is clear that other and unknown factors are involved. A growing body of evidence supports the concept that local and systemic inflammatory play a role in the initiate and progression of atherosclerosis and its complication. C-reactive protein(CRP) is an actue-phase reactant marker for underlying systemic inflammation. CRP has been reported to be evaluated in patients with actue ischemic and AMI. Because routine determination to CRP can not indicate the low level variability of concentration to CRP(0.1-10mg/L), hs-CRP is more efficient as a predictor to CHD.Inflammatory mediators are inimately associated with cascade ofevents leading to atherosclerotic plaque initiation, development and rupture. Along with increasing experimental evidence implicating inflammatory and immune reactions in atherothrombosis, a wide range of circulating markers of inflammation predict cardiovascular risk in a variety of clinical settings.Lately study revealed that Interleukin-18(1L-18) , a powerful regulator of immunology and inflammation, has been expressed in human atherosclerotic plaque, mediating Interferon(IFN)-y release locally. IL-18 ,originally identified as an IFN-r inducing factor in Kupffer cells and macrophages, play a central role in the inflammatory cascade and in the process of innate and acquired immunities because of its ability to induce IFN-r production in T lymphocytes and nature killer cells , which is believed to play a crucial role in atherosclerotic plaque rupture.ObjectiveCHD is a complex trait in which inherited and inviromental risk factors interact to drive the disease process. The fact that classical cardiovasclular risk factors are not pressed in all patients suffering from the treatment of these factors is about 30%, prompted several groups to explore other factors which could be involved in the pathgensis of atherosclerosis and thrombosis process. The objietive of the present study is to test whether hs-CRP and IL-18 correlate with variefied grade of heart function ,SA and UA,PTCA and whether hs-CRP and IL-18 can also be risk factors of CHD.MethodsIn the study of 200 unrelated patients with documented CHD(148 men and 52 women , mean age 52.5+16 years) and 80 unrelated normal subjects(55 men and 25 women, mean age 48.3+11.4 years) , we measured baseline serum concentration of hs-CRP and IL-18 .For PTCA patients, we measured two times (half an hour before and after opration). Statistic analyses wre performed with the SPSS 10.0. Value were considered statistically significant at P<0.05.Results1 .Hs-CRP levels were higher in patients whose function were II and III (3.33+1.26mg/L, 9.55+4.86 mg/L) compaired with control group (0.55+0.15 mg/L) (P<0.05); so as to IL-18 (78.3+26.7 pg/mL and 109.5+58.4 pg/mL versus 46.8+13.2 pg/mL) (P<0.05).; But the difference between subjects of heart function I (hs-CRP:0.62+0.17mg/L,IL-18: 49.9+12.8pg/mL) and normal was not significant ( P>0.05 ); Hs-CRP and IL-18 are related to heart function in relation analysis.2 .Serum concentrations of hs-CRP ( 8.65+3.31 mg/L, 12.33+5.21 mg/L ) and IL-18( 85.7+48.9 pg/mL, 188.2+62.4 pg/mL ) were significantly higher among SA group and UA group than among control group ( P<0.01 ).3. Hs-CRP (before PTCA: 8.55+3.52 mg/L, after PTCA: 15.8+9.66 mg/L ) and IL-18(before PTCA : 96.6+28.9 pg/mL, after PTCA:144.6+48.8 pg/mL ) levels were significantly higher in PTCA group compaired with control group (P<0.01); futhermore hs-CRP and IL-18 were higher among after operation group than before operation group ( P<0.05) .4.Hs-CRP(22.3+10.86 mg/L),IL-18(205.6+69.8 pg/mL) in patients after PTCA with restenosis were higher than those wit...