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目的：探讨冠心病患者血清白介素18 （Interleukin-18, IL-18）、白细胞分化抗原40 配体（CD40L）、及高敏C 反应蛋白（hs-CRP）水平在经皮冠状动脉介入术治疗前后的变化和意义。方法：选择经冠状动脉造影确诊的冠心病患者85 例，根据病变程度分为单支病变组（n=32）、双支病变组（n=28）和多支病变组（n=25），采用双抗体夹心ELISA 法测定PCI 术前术后血清IL-18、 CD40L 和hs-CRP 水平。结果：血清IL-18 水平测定结果：多支病变组高于双支病变组，双支病变组高于单支病变组；支架置入术后显著高于术前，差异均有统计学意义（P<0.01）。血清CD40L 水平测定结果：多支病变组高于双支病变组和单支病变组，差异均有统计学意义（P<0.01）, 双支病变组与单支病变组间差异无统计学意义（P>0.05）；支架置入术后较术前显著升高，差异有统计学意义（P<0.01）。血清hs-CRP 水平测定结果：多支病变组高于双支病变组，双支病变组高于单支病变组；支架置入术后显著高于术前，差异均有统计学意义（P<0.01）。结论：冠心病患者血清IL-18、CD40L 和hs-CRP 与冠脉病变程度密切相关，介入治疗可使冠心病患者血清IL-18、CD40L 和hs-CRP 水平升高，监测血清中IL-18、CD40L 和hs-CRP 水平变化可了解治疗效果和炎症程度。

英文摘要:

Objective: To evaluate the effects of PCI on serum IL-18, sCD40L and hs-CRP levels in patients with coronary artery disease. Methods: 85 hospitalized patients diagnosed with coronary heart disease through coronary arteriongraphy were enrolled as study group. According to lesions, the patients were divided into single-vessel disease (n=32), double vessel disease (n=28) and multi-vessel group (n=25). 5ml blood sample were collected from peripheral vein before and after percutaneous coronary intervention in every patient. The serum IL-18, sCD40L and hs-CRP levels were measured by ELISA methods. Results: The results of serum IL-18 levels: multi-vessel group was higher than double vessel disease, and double vessel disease group than in single-vessel disease (both p<0.01). The levels of serum IL-18 in CHD patients after PCI were higher than that before PCI (p<0.01). The results of serum CD40L levels: multi-vessel lesions were higher than double vessel disease and single vessel disease group, the difference was statistically significant (P <0.01), double vessel disease and single vessel disease was no significant difference between the groups (P> 0.05). The levels of serum IL-18 in CHD patients after PCI were higher than that before PCI (p<0.01). The results of serum hs-CRP levels: multi-vessel group was higher than double vessel disease, and double vessel disease group than in single-vessel disease (both p<0.01). The levels of serum IL-18 in CHD patients after PCI were higher than that before PCI (p<0.01). Conclusions: The serum IL-18, sCD40L and hs-CRP levels were significantly correlated with coronary artery disease; this suggested that there were high inflammatory response state in CHD patients. Inflammatory factors increased significantly in the patients with CHD after PCI, which indicate that detection and management of the levels of serum inflammatory factors may improve inflammatory state in patients with CHD.

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