冠心病患者核因子κB的变化及其临床意义

摘要

目的 探讨冠心病(CHD)患者外周血核因子κB(NF-κB)的变化及其临床意义.方法 入选163例患者,CHD组103例,其中ACS组71例,SAP组32例,对照组60例.检测外周血浆NF-κB浓度.同时经选择性冠状动脉造影检查.比较不同冠状动脉病变支数、冠状动脉病变程度、冠状动脉病变类型的血浆NF-κB水平;并进行冠心病患者 Gensini积分与NF-κB等危险因素的多因素logistic回归分析.结果 ①ACS组、SAP组与对照组相比NF-κB浓度明显升高,且ACS组较SAP组升高更明显,差异有统计学意义(P＜0.01);②单支、双支、三支病变组、对照组各组间NF-κB浓度比较差异有统计学意义(P＜0.01),但单支病变组与对照组比较差异无统计学意义;③轻度、中度、重度病变组、对照组各组间NF-κB浓度比较差异有统计学意义(P＜0.01),但轻度病变组与对照组比较差异无统计学意义;④A型、B型、C型病变组、对照组各组间NF-κB浓度比较差异有统计学意义(P＜0.01),但A型病变组与对照组比较差异无统计学意义;⑤Gensini积分与CHD危险因子logistic回归分析显示高水平核因子κB、高血压、高脂血症、年龄＞60岁、男性均为严重冠状动脉病变的相关危险因素.结论 CHD患者NF-κB活性增高,是严重冠脉病变的相关危险因素,在CHD发生、发展中可能起着重要作用.%Objective To investigate the changes and clinical significance of peripheral plasma nuclear factor-KB ( NF-κB ) in the patients with coronary heart disease ( CHD ). Methods There were totally 163 patients selected, and 103 in CHD group including 71 in acute coronary syndrome group ( ACS group ) and 32 in stable angina pectoris group ( SAP group ),and 60 in control group. The concentration of NF-κB in peripheral plasma was detected,and at the same time, coronary angiography ( CAG ) was used selectively for defining the pathological changes of coronary artery. The level of plasma NF-κB was observed among different vessels, status and types of CHD, and Gensini integrals and CHD risk factors including NF-κB were given Logistic regression analysis. Results ①The concentration of NF-κB increased significantly in ACS group and SAP group compared with control group, which was more significant in ACS group than that in SAP group ( P <0. 01 ). ②The comparison in the concentration of NF-κB was statistically different among single vessel group,two vessel group,three vessel group and control group ( P <0. 01 ),but that was not statistically different between single vessel group and control group. ③The comparison in the concentration of NF-κB was statistically different among mild group,medium group,severe group and control group ( P <0. 01 ) ,but that was not statistically different between mild group and control group. ④The comparison in the concentration of NF-κB was statistically different among type A group,type B group,type C group,type D group and control group ( P <0. 01 ),but that was not statistically different between type A group and control group. ⑤The Logistic regression analysis of Gensini integrals and CHD risk factors showed that high level of NF-κB,hypertension,high blood fat,age over 60 and male were all risk factors of severe CHD. Conclusion The increase of NF-κB activity is a relative risk factor of severe coronary disease in CHD patients,which plays an important role in the occurrence and development of CHD.