冠心病患者血清NLRP3炎性小体、NF-κB的表达及其与Gensini评分的关系

Expression of NLRP3 inflammatory corpuscles and NF-κB in serum and its relationship with Gensini score in patients with coronary heart disease

目的探讨冠心病患者血清核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)炎性小体、核因子-κB(NF-κB)的表达,及其与冠状动脉Gensini评分的关系。方法纳入于2016年1月至2018年12月在河南省胸科医院住院的冠心病患者120例,分为稳定型心绞痛(SAP)组患者40例、不稳定型心绞痛(UAP)患者组40例与急性心肌梗死(AMI)患者组40例,选取同期30名冠脉造影未见异常或狭窄<50%作为对照组。应用ELISA法检测四组血清NLRP3炎性小体、NF-κB的表达水平;根据冠状动脉造影结果对各组患者进行Gensini评分;采用秩和检验分析血清NLRP3、NF-κB水平和Gensini评分的相关性。结果(1)SAP组、UAP组和AMI组患者血清NLRP3、NF-κB的表达水平均明显高于对照组,差异有统计学意义(t值分别为9.758、11.734、14.361,P<0.01),且AMI组明显高于SAP组和UAP组,差异有统计学意义(t值分别为11.392、10.716,P<0.05)。(2)根据冠状动脉造影结果计算Gensini积分:SAP组[(45.37±8.26)分]、UAP组[(58.47±18.54)分]、AMI组[(78.72±22.35)分]均明显高于对照组[(18.21±4.63)分],差异有统计学意义(P<0.05),且AMI组Gensini积分较其他三组明显增加,差异有统计学意义(P<0.01)。(3)采用Spearman相关性分析显示:血清NLRP3水平与Gensini积分呈正相关(相关指数r=0.496、P<0.001);血清NF-κB水平与Gensini积分亦呈正相关(相关指数r=0.506、P<0.001),随着炎症因子水平的升高,冠脉Gensini积分亦上升。结论NLRP3炎性小体、NF-κB与冠心病发展存在密切关系,其水平与Gensini评分均呈正相关,提示二者在冠心病发生发展过程中起着一定作用,有可能成为评估冠状动脉血管狭窄程度的预测因子。

Objective To investigate the expression of serum nucleotides-binding oligomerization domain-like receptor protein 3(NLRP3)inflammatory corpuscles and nuclear factor-κB(NF-κB)in patients with coronary heart disease(CAD)and its relationship with coronary artery Gensini score.Methods A total of 120 patients with coronary heart disease were enrolled in Henan Chest Hospital from January 2016 to December 2018.There were forty patients with stable angina pectoris group(SAP),forty patients with unstable angina pectoris group(UAP)and forty patients with acute myocardial infarction group(AMI).Thirty patients with no abnormal coronary angiography or stenosis<50%in the same period were selected as the control group.ELISA method was used to detect the expression of NLRP3 inflammatory corpuscles and NF-κB in serum in four groups,Gensini score was performed according to the results of coronary angiography,and rank sum test was used to analyze the correlation between the levels of serum NLRP3,NF-κB and Gensini scores.Results(1)The levels of NLRP3 and NF-κB in serum in SAP group,UAP group and AMI group were significantly higher than those in control group(t=9.758,11.734,14.361,P<0.01 respectively),and those of the AMI group were significantly higher than those of the SAP group and UAP group(t=11.392,10.716,P<0.01).(2)According to the results of coronary angiography,the Gensini score in the SAP group was significantly higher than that in the control group,and the Gensini score in the AMI group was significantly higher than that in the other three groups(P<0.05).According to the results of coronary angiography,the Gensini score in the AMI group was significantly higher than that in the control group(P<0.05).(3)Spearman correlation analysis showed that there was positive relationship between serum NLRP3 level and Gensini score(r=0.496,P<0.001),and between serum NF-κB level and Gensini score(r=0.506,P<0.001).With the increase of the level of inflammatory factors,the coronary Gensini score also increased.Conclusions NLRP3 inflammatory corpuscles and NF-κB are closely correlated with the development of coronary heart disease,and their levels are positively correlated with Gensini score,suggesting that NLRP3 inflammatory bodies and NLRP3 may play a role in the occurrence and development of coronary heart disease and may be used as predictors of coronary artery stenosis.