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目的:探讨急性冠状动脉(冠脉)综合征(ACS)患者核因子kappaB(NF-κB)和基质金属蛋白酶9(MMP-9)的变化及临床意义。方法:入选163例患者,冠心病患者103例,其中冠脉综合症患者71例,稳定性心绞痛(SAP)患者32例,另60例冠脉造影阴性患者作为对照。检测患者外周血浆NF-κB和MMP-9浓度。同时经选择性冠脉造影检查,明确冠脉病变情况。结果:①冠脉综合症患者、稳定性心绞痛患者较对照患者血浆NF-κB、MMP-9浓度明显升高,且冠脉综合症患者较稳定性心绞痛患者升高更明显,差异均有统计学意义(P<0.05);②冠脉综合症患者双支、三支病变患者血浆NF-κB较单支病变及对照患者明显升高,三支病变患者较双支病变患者升高更明显,差异均有统计学意义(P<0.05),单支、双支、三支病变患者及对照患者血浆MMP-9浓度两两比较差异均有统计学意义(P<0.05)③冠脉综合症重度病变患者血浆NF-κB较中度、轻度病变及对照患者均显著升高,差异均有统计学意义(P<0.05),轻度、中度、重度病变及对照患者血浆MMP-9两两比较差异均有统计学意义(P<0.05)④MMP-9与NF-κB呈正相关;⑤Gensini积分与冠心病非传统危险因子多重线性回归分析,提示hs-CRP、MMP-9、NF-κB均为冠心病的危险因子。结论:NF-κB和MMP-9均为冠心病的危险因子,尤其在冠脉综合症患者,随着NF-κB水平的增加MMP-9的水平增加更明显,NF-κB可能通过对MMP-9的调节在冠脉综合症发病过程中可能起作用。
Objective: To investigate the changes and clinical significance of NF-κB and MMP-9 in patients with acute coronary syndrome (ACS). Methods: A total of 163 patients were enrolled, including 103 coronary heart disease patients, including 71 patients with coronary syndrome, 32 patients with stable angina pectoris (SAP) and 60 patients with negative coronary angiography. Peripheral blood plasma concentrations of NF-κB and MMP-9 were measured. At the same time by selective coronary angiography, a clear coronary disease. Results: ① In patients with coronary syndrome, the concentrations of plasma NF-κB and MMP-9 in patients with stable angina pectoris were significantly higher than those in patients with coronary heart disease, and the patients with coronary syndrome were more significantly elevated than patients with stable angina pectoris (P <0.05) .②The plasma levels of NF-κB in patients with coronary artery disease and coronary artery disease were significantly higher than those in single-vessel disease and control patients, and those with three-vessel disease were significantly higher than those with double-vessel disease (P <0.05). The levels of plasma MMP-9 in patients with single branch, double branch, three lesions and control patients were significantly different in any pairwise comparison (P <0.05) .③The severity of coronary syndrome The plasma levels of NF-κB in patients with mild, moderate and severe grade and control were significantly higher than those in moderate and mild cases and those in control group (P <0.05) (P <0.05) ④MMP-9 was positively correlated with NF-κB; ⑤ Multiple linear regression analysis of Gensini integral and non-traditional risk factors of coronary heart disease suggested that hs-CRP, MMP-9 and NF- Heart disease risk factors. Conclusion: Both NF-κB and MMP-9 are risk factors of coronary heart disease. Especially in patients with coronary syndrome, the level of MMP-9 increases with the increase of NF-κB. NF- 9 regulation may play a role in the pathogenesis of coronary syndrome.