急性冠状动脉综合征患者外周血单个核细胞核因子κB活性的测定及临床意义

Measurement and Clinical Significance of Activation of Nuclear Factor-kappa B in Peripheral Blood Mononeuclear Cells in Patients with Acute Coronary Syndromes

测定急性冠状动脉综合征患者外周血单个核细胞中核因子κB活性 ,研究核因子κB活性与C反应蛋白、斑块稳定型等的关系 ,以明确核因子κB对急性冠状动脉综合征的判断价值。测定入院时 30例急性冠状动脉综合征患者、14例稳定型心绞痛患者、15例高血压患者和 15例正常对照者外周血单个核细胞核因子κBp5 0吸光度值 ,以及急性冠状动脉综合征患者入院后 2周的外周血单个核细胞核因子κBp5 0吸光度值 ,并行血压、血脂、血C反应蛋白等检查。结果发现 ,入院时急性冠状动脉综合征组 (急性心肌梗死和不稳定型心绞痛组 )的核因子κBp5 0吸光度值为 0 .6 94± 0 .16 ,与稳定型心绞痛组和高血压组比较有显著性差异 (P <0 .0 1)。入院两周后 ,急性冠状动脉综合征组 (n =2 8)核因子κBp5 0吸光度值降低 (0 .15 7± 0 .0 5 9) ,与入院时相比差异显著 (P <0 .0 1)。急性冠状动脉综合征组患者的外周血单个核细胞核因子κBp5 0的吸光度值与血糖水平有正相关关系 (r=0 .5 12 ,P <0 .0 1) ,与血清C反应蛋白水平有正相关关系 (r=0 .771,P <0 .0 1)。结果提示急性冠状动脉综合征患者外周血单个核细胞核因子κB的活性增高 ,可以反映斑块的不稳定型与破裂 。

Aim To measure the activity of nuclear factor-κB (NF-κB) of the peripheral blood mononucleus cells (PBMC) of patient which had acute coronary syndrome (ACS) or stable angina or hypertension, study its relationship with C-reactive protein (CRP), plaque stability and determine its value in the diagnosis of ACS. Methods We compared the results of the activity of nuclear factor-κB and levels of CRP in ACS aged 48-80 years with that of the stable angina (SA) or hypertension as controls. Results OD of NF-κB p50 of PBMC and CRP in ACS group on admission was significantly higher than that in SA group and hypertension group (P<0.01), OD of NF-κB p50 of PBMC and CRP in AMI group on admission was significantly higher than that in UA group (P<0.05). OD of NF-κB p50 of PBMC and CRP in SA group had no difference from that in hypertension group. After two weeks, OD of NF-κB p50 of PBMC in ACS group was significantly decreased compared with that on admission (P<0.01). There was no difference between SA group and hypertension group. There was a positive correlation between OD of NF-κB p50 of PBMC and blood glucose level (r=0.512, P<0.01) in ACS group. OD of NF-κB p50 of PBMC also had a positive correlation with serum CRP level(r=0.771, P<0.01). Conclusions The activation of NF-κB in peripheral blood mononucleus cells may be a predictor of the coronary plaque instability and disruption, and it might be helpful in the diagnosis of ACS.