Abstract：ObjectiveTo investigate the correlation between different degrees of coronary vascular lesion and serum tumor necrosis factor-α (TNF-α) and vascular endothelial growth factor (VEGF) levels in patients with acute coronary syndrome (ACS). MethodsSixty patients with ACS were chosen from the Department of Cardiology at Jilin Central Hospital from January 2020 to October 2022. According to the clinical manifestations, coronary angiography (CAG), and optical coherence tomography (OCT) detection results, 60 patients were divided into unstable angina pectoris (UAP) group (n=20), non-ST-segment elevation myocardial infarction (NSTEMI) group (n=18), and ST-segment elevation myocardial infarction (STEMI) group (n=22). The serum levels of TNF-α and VEGF were detected in each group, and the correlation between the different degrees of vascular lesions, plaque characteristics, and TNF-α and VEGF levels in each group were analyzed. ResultsSerum TNF-α level in the UAP group ［(4.99±0.27)μg/L］ was significantly different from that in the NSTEMI group ［(5.62±0.32)μg/L］ and the STEMI group ［(5.77±0.42)μg/L］ (t=6.58, 7.08, all P＜0.05). The serum levels of TNF-α and VEGF were significantly different between the single-vessel disease group ［(3.34±0.32)μg/L, (310.94±67.83)μg/L］ and the multi-vessel disease group ［(5.87±0.46)μg/L, (388.32±143.59)μg/L］(t=19.21, 2.12, all P＜0.05). The serum TNF-α level in the severe stenosis group［(5.19±0.47)μg/L］ was higher than that in the mild stenosis group ［(3.55±0.28)μg/L］and moderate stenosis group ［(3.64±0.42)μg/L］, and the differences were statistically significant (t=12.72, 11.25, all P＜0.05). Serum TNF-α levels in the vulnerable plaque group ［(4.36±0.87)μg/L］ and plaque rupture group ［(5.86±0.33)μg/L］ were higher than those in other plaque types groups ［(2.99±0.77)μg/L in fibrous plaque group, (3.35±0.65)μg/L in lipid plaque group, (2.79±0.31)μg/L in calcified plaque group, and (2.83±0.34)μg/L in macrophage infiltration group］, the differences were statistically significant (t=4.65, 3.10, 4.89, 5.62, 5.00, 11.41, 11.72, 5.62, 20.86, 20.56, all P＜0.05). No significant differences were observed in the levels of VEGF among the various groups. Serum TNF-α level was statistically significant linked with serum VEGF level (r=0.118) and serum Gensini score (r=0.241). The thickness of the detected coronary plaque fiber cap in the UP group ［(57.92±18.22)μm］ was less than that in the SP group ［(217.17±105.23)μm］ . The curvature of lipid pool, the ratio of microchannel, lumen thrombosis, macrophage infiltration and cholesteral crystal in the UP group ［(207.23±65.56)°, 9/29(31.03%), 4/29(13.79%), 15/29(51.72%), 15/29(51.72%)］, were all higher than those in the SP group ［(143.65±34.12) °, 3/31(9.68%)， 0/31, 4/31(12.90%), 3/31(9.68%)］, the differences were statistically significant (t=2.11, 2.45, χ2=0.00, 0.07, 0.22, 0.09, all P＜0.05). The serum level of TNF-α in UP group ［(4.76±0.68)μg/L］ was higher than that in SP group ［(3.44±0.25）μg/L］ (t=6.59,P＜0.05). There was no significant difference in Gensini scores between the UP group ［35.90(22.91, 71.01)points］ and the SP group ［27.60(18.50, 45.42)points］ (Z=3.58, P＞0.05). ConclusionsWith the increase in the number of coronary vascular lesions and the aggravation of vessel stenosis, the serum TNF-α level shows an upward trend. Serum TNF-α levels are higher in ACS patients with vulnerable plaque and plaque rupture.
颜凡辉 赵明俐 李颖 郭方明 詹景冬 赵英杰 王阳 张艳芬 赵笑梅. 急性冠脉综合征患者冠脉血管病变程度
与血清TNF-α、VEGF水平相关性研究[J]. 中华诊断学电子杂志, 2023, 11(3): 158-164.
Yan Fanhui, Zhao Mingli, Li Ying, Guo Fangming, Zhan Jingdong, Zhao Yingjie, Wang Yang, Zhang Yanfen, Zhao Xiaomei. Study on the correlation between the degree of coronary vascular lesion and serum levels of TNF-α and VEGF in patients with acute coronary syndrome. zhzdx, 2023, 11(3): 158-164.
