单核细胞核因子κB与老年冠心病患者临床类型及预后的关系

Correlation of NF-κB with clinical types and prognosis of senile CHD

目的探讨单核细胞NF-κB水平与老年冠心病患者临床类型及预后的关系。方法老年冠心病患者依据临床特点分为稳定型心绞痛组(SAP组40例),不稳定型心绞痛组(UAP组40例),急性心肌梗死组(AMI组40例),同时设对照组。所有患者检测血脂、血糖、hs-CRP和NF-κB,综合治疗并随访1年,观察不良事件的发生情况(MACE)。结果(1)与对照组相比,病例组hs-CRP、NF-κB水平均明显升高,差异具有统计学意义(P<0.01);而AMI组、UAP组与SAP组相比hs-CRP、NF-κB水平差异也具有统计学意义(P<0.01)。AMI组该指标也较UAP组显著升高(P<0.01);(2)相关分析发现各病例组NF-κB与hs-CRP呈正相关。(3)与SAP组相比,AMI组、UAP组MACE发生率明显升高(P<0.01)。AMI组与UAP组MACE发生率也有明显差异(P<0.01)。结论 NF-κB可能参与了冠心病的发病。联合检测hs-CRP和NF-κB,有助于老年冠心病患者危险分层和评估预后。

Objective To investigate the correlation of NF - κB level in mononuclear cells from peripheral blood with clinical types and prognosis of the senile coronary heart disease （CHD）. Methods According to clinical characteristics, 120 senile CHD patients were equally divided into three groups, stable angina pectoris（ SAP）, unstable angina（ UAP）, and acute myocar- dial infarction（AMI）. In addition, age- matched normal persons served as control group. Measured laboratory parameters in- clude blood lipids, glucose, hs - CRP, and the level of NF - κB in peripheral blood using flow cytometry. Patients were kept their ongoing comprehensive treatment and followed up for one year. The occurrence of major adverse coronary events（MACE） were observed. Results The levels of hs - CRP and NF - κB in CHD groups including AMI, UAP, and SAP were significantly increased than that in normal control group, and the differences were statistically significant （P 〈 0.01 ）. Levels differences of hs -CRP and NF -κB among the AMI group, UAP group and SAP group had statistical significance（P 〈0.01 ）. The levels of hs - CRP and NF - κB from the AMI group significantly increased compared with UAP group, and the differences were also sta- tistically significant（ P 〈 0.01 ） ; The correlation analysis showed that NF - κB was positively correlated with hs - CRP; The oc- currences of MACE from groups of AMI and UAP were significantly higher than that of the SAP group（ P 〈 0.01 ） and the occur- rences of MACE had significant difference between the AMI group and the UAP group（P 〈 0.01 ）. Conclusion NF -κB might be participated in the pathogenesis of CHD, and be closely associated with the clinical types of the senile CHD patients. Joint detection of hs - CRP and NF - κB may be valuable clinical markers for CHD diagnosis, and prognosis can be predicted.