高迁移率族蛋白1和髓过氧化物酶预测冠状动脉病变程度和斑块易损性的临床研究  

Roles of high mobility group box-1 protein and myeloperoxidase deficiency in evaluating coronary stenosis and predicting vulnerability of atherosclerotic plaques

作　　者：黄景欢[1] 刘洋[1] 马冬冬[1] 刘同涛[1] 陈文强[1] 杨发林[1] HUANG Jing-huan;LIU Yang;MA Dongdong;LIU Tong-tao;CHEN wen-qiang;YANG Fa-lin(Department of Cardiology,Qilu Hospital of Shandong University,Jinan 250012,China)

机构地区：[1]山东大学齐鲁医院心内科,250012

出　　处：《中华老年医学杂志》2013年第1期9-13,共5页Chinese Journal of Geriatrics

基　　金：国家自然科学基金资助项目(30871040,30971216);山东省自然科学基金资助项目(Y2008C17)

摘　　要：目的研究高迁移率族蛋白1(HMGB1)、髓过氧化物酶(MPO)在预测冠状动脉(冠脉)病变程度和粥样硬化易损斑块破裂中的作用。方法对50例急性心肌梗死(AMI)、50例不稳定型心绞痛(UAP)及50例稳定型心绞痛(SAP)患者分别进行冠脉造影(CAG)和选择性血管内超声(IVUS)检查以判断冠脉管腔狭窄程度、斑块性质及斑块破裂和血栓形成情况。30例CAG正常的患者为对照组。酶联免疫吸附法(EuSA)检测4组患者血清HMGB和MPO的水平,透视免疫法测定高敏c-反应蛋白(hsC-RP)水平。Gensini评分分析冠脉病变程度,相关性分析判断HMGB、MPO及hsC—RP与IVUS结果和Gensini评分的关系。结果AMI和uAP组的HMGB、MPO及hs-CRP血清水平高于SAP组和对照组(均P〈0.01),AMI组高于UAP组(P〈0.05)。IVUS结果显示AMI和UAP组主要为脂质性斑块,分别为51.3Yoo(20/39)和46.7Voo(43/92),而SAP组主要为纤维性斑块,脂质斑块仅占17.2%(15/87)。与SAP组比较,AMI和UAP组斑块负荷和血管重构指数增大(均P〈0.01)。AMI组HMGB、MPO水平分别与Gensini评分及IVUs测得的重构指数呈正相关(r值分别为0.54、0.48,均P〈0.05),UAP组HMGB、MPO分别与Geasini评分及IVUs测得的斑块负荷呈正相关(r值分别为0.43、0.56,均P〈0.05)。结论HMGB和MPO与冠脉狭窄程度呈正相关,可作为判断ACS病情严重程度的预测指标;HMGB和MPO与斑块的不稳定及破裂关系密切。Objective To elucidate the roles of high mobility group box-1 protein(HMGB1)and myeloperoxidase(MPO)deficiency in evaluating coronary stenosis and the vulnerability of atherosclerotic plaques in patients with coronary heart disease.Methods Totally 50 patients with acute myocardial infarction(AMI),50 patients with unstable angina peetoris(UAP),50 patients with stable angina pectoris(SAP)and 30 patients without coronary heart disease underwent the study.Coronary arteriography(CAG)and intravascular ultrasound(IVUS)were performed to analyze coronary stenosis and plaque characteristics and then gensini score was calculated.Concentrations of HMGB1,MPO and hypersensitive C reactive protein(hsC-RP)were measured by means of enzymelinked-immonosorbent assay(ELISA).Results Concentrations of HMGB1,MPO and hsC-RP were significantly higher in AMI and UAP patients than in SAP patients(all P^0.01).IVUS showed that 51.3 O//oo(20/39)AMI patients,46.70//00(43/92)UAP patients had soft lipid-rich plaques,while 52.9~//00(46/87)SAP patients had fibrous plaques,only 17.2%(15/87)had soft plaques.AMI and UAP patients had larger plaque burden and vascular remodeling index than did the SAP patients(both P〈0.01).In AMI group,HMGB1 and MPO levels were correlated well with gensini score and remodeling index measured by IVUS,respectively(r=0.54,0.48,allP〈0.05),while in UAP group,HMGB1 and MPO levels were correlated well with gensini score and plaque burden measured by IVUS,respectively(r=0.43,0.56,all P〈0.05).Conclusions HMGB1 and MPO are positively correlated with coronary stenosis,which can be used to predict the severity of ACS.HMGB1 and MPO are associated closely with plaque vulnerability and rupture.

关 键 词：动脉粥样硬化 高迁移率族蛋白质类 氧化物酶 C反应蛋白质 

分 类 号：R541.4[医药卫生—心血管疾病]