空气细颗粒物（PM2.5）对心血管疾病住院患者炎症因子的影响

doi:10.3877/cma.j.issn.1674-6880.2017.04.006

目的

探讨空气细颗粒物PM2.5对心血管疾病住院患者相关炎症因子的影响。

方法

纳入2015年10月至2016年4月吉林大学中日联谊医院住院的心血管疾病患者共计92名，同期记录入院当天中国环境保护部发表的PM2.5浓度值数据，根据PM2.5浓度值将所有患者分成优良组（0 < PM2.5 ≤ 75 μg/m²，20例），轻度组（75 μg/m² < PM2.5 ≤ 115 μg/m²，20例）及中重度组（PM2.5 > 115μg/m²，52例）。记录所有患者的一般资料及入院时患者的中性粒细胞计数（NEUT）、血小板计数（PLT）计数。采用酶联免疫吸附试验测定血清白细胞介素8（IL-8）以及细胞间黏附分子1（ICAM-1）的表达水平。采用Spearman相关分析PM2.5与PLT、IL-8、ICAM-1的相关性。

结果

三组心血管疾病住院患者NEUT间比较，差异无统计学意义（Z = 1.312，P > 0.05），PLT、IL-8以及ICAM-1水平比较，差异均有统计学意义（Z = 4.541、3.084、5.065，P均< 0.05），且PLT [237（181，275）× 10⁹/L、212（170，241）× 10⁹/L、184（140，213）× 10⁹/L]及ICAM-1 [1 706（900，2 999）、683（381，960）、262（163，341）ng/L]水平中重度组及轻度组均明显高于优良组，且中重度组更高（P均< 0.017），而IL-8 [47（20，52）、60（45，77）、147（89，199）ng/L]水平仅优良组及轻度组均显著低于中重度组患者（P均< 0.001）。Spearman相关分析发现，PM2.5与PLT呈负相关（r = -0.290，P = 0.018），与IL-8、ICAM-1呈正相关（r = 0.603，P = 0.043；r = 0.766，P = 0.013）。

结论

随着PM2.5浓度的增加，PLT水平明显上升，血清IL-8以及ICAM-1的表达水平亦越高。

关键词: 空气细颗粒物, PM2.5, 心血管疾病, 炎症

Objective

To investigate the effect of air fine particulate matter (PM2.5) on inflammation factors of inpatients with cardiovascular disease.

Methods

Totally 92 patients with cardiovascular disease admitted to the China-Japan Friendship Hospital Affiliated Jilin University from October 2015 to April 2016 were enrolled in this study. The data of PM2.5 density published by China's Ministry of Environmental Protection on the day of admission was recorded. The patients were divided into the good group (0 < PM2.5 ≤ 75 μg/m², 20 cases), the light group (75 μg/m² < PM2.5 ≤ 115 μg/m², 20 cases), and the moderate-severe group (PM2.5 > 115 μg/m², 52 cases) according to the concentration of PM2.5. The general information, neutrophil count (NEUT) and platelet count (PLT) were recorded on the day of admission. The levels of serum interleukin-8 (IL-8) and intercellular adhesion molecule-1(ICAM-1) were detected by enzyme-linked immunesorbent assay. The relationship between PM2.5 concentration and PLT, IL-8, ICAM-1 were analyzed by Spearman correlation analysis.

Results

There was no significant difference in the NEUT among these three groups (Z = 1.312, P > 0.05), and the levels of PLT, IL-8 and ICAM-1 all showed significant differences among them (Z = 4.541, 3.084, 5.065, all P < 0.05). In addition, the PLT [237 (181, 275) × 10⁹/L, 212 (170, 241) × 10⁹/L, 184 (140, 213) × 10⁹/L) and ICAM-1 [1 706 (900, 2 999), 683 (381, 960), 262 (163, 341) ng/L] in the moderate-severe group and light group were higher than those in the good group, and were highest in the moderate-severe group (all P < 0.017). However, the IL-8 levels [47 (20, 52), 60 (45, 77), 147 (89, 199) ng/L] in the good group and light group were both lower than that in the moderate-severe group (all P < 0.001). The Spearman correlation analysis indicated that PM2.5 concentration was negatively correlated with PLT (r = -0.290, P = 0.018), and was positively correlated with IL-8 and ICAM-1 (r = 0.603, P = 0.043; r = 0.766, P = 0.013).

Conclusion

With the increased concentration of PM2.5, the levels of PLT, IL-8 and ICAM-1 in inpatients with cardiovascular disease also increased significantly.

Key words: Air fine particulate matter, PM2.5, Cardiovascular disease, Inflammation

表1 三组不同PM2.5浓度心血管疾病患者相关炎症因子的比较[M（P₂₅，P₇₅）]

组别	例数	NEUT（× 10⁹/L）	PLT（× 10⁹/L）	IL-8（ng/L）	ICAM-1（ng/L）
优良组	20	4.5（3.4，6.0）	184（140，213）	47（20，52）	262（163，341）
轻度组	20	4.9（4.0，7.8）	212（170，241）^a	60（45，77）	683（381，960）^a
中重度组	52	4.88（4.13，6.57）	237（181，275）^ab	147（89，199）^ab	1 706（900，2 999）^ab
Z值	?	1.312	4.541	3.084	5.065
P值	?	0.275	0.013	0.049	0.008

表1 三组不同PM2.5浓度心血管疾病患者相关炎症因子的比较[M（P₂₅，P₇₅）]

组别	例数	NEUT（× 10⁹/L）	PLT（× 10⁹/L）	IL-8（ng/L）	ICAM-1（ng/L）
优良组	20	4.5（3.4，6.0）	184（140，213）	47（20，52）	262（163，341）
轻度组	20	4.9（4.0，7.8）	212（170，241）^a	60（45，77）	683（381，960）^a
中重度组	52	4.88（4.13，6.57）	237（181，275）^ab	147（89，199）^ab	1 706（900，2 999）^ab
Z值	?	1.312	4.541	3.084	5.065
P值	?	0.275	0.013	0.049	0.008

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Effect of air fine particulate matter (PM2.5) on inflammation factors of inpatients with cardiovascular disease

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Effect of air fine particulate matter (PM2.5) on inflammation factors of inpatients with cardiovascular disease