CAJ | 학술논문

目的研究高迁移率族蛋白1 (HMGB1)、髓过氧化物酶(MPO)在预测冠状动脉(冠脉)病变程度和粥样硬化易损斑块破裂中的作用. 方法对50例急性心肌梗死(AMI)、50例不稳定型心绞痛(UAP)及50例稳定型心绞痛(SAP)患者分别进行冠脉造影(CAG)和选择性血管内超声(IVUS)检查以判断冠脉管腔狭窄程度、斑块性质及斑块破裂和血栓形成情况.30例CAG正常的患者为对照组.酶联免疫吸附法(ELISA)检测4组患者血清HMGB1和MPO的水平,透视免疫法测定高敏C-反应蛋白(hsC-RP)水平.Gensini评分分析冠脉病变程度,相关性分析判断HMGB1、MPO及hsC-RP与IVUS结果和Gensini评分的关系. 结果 AMI和UAP组的HMGB1、MPO及hsCRP血清水平高于SAP组和对照组(均P＜0.01),AMI组高于UAP组(P＜0.05).IVUS结果显示AMI和UAP组主要为脂质性斑块,分别为51.3 ％(20/39)和46.7％(43/92),而SAP组主要为纤维性斑块,脂质斑块仅占17.2％(15/87).与SAP组比较,AMI和UAP组斑块负荷和血管重构指数增大(均P＜0.01).AMI组HMGB1、MPO水平分别与Gensini评分及IVUS测得的重构指数呈正相关(r值分别为0.54、0.48,均P＜0.05),UAP组HMGB1、MPO分别与Gensini评分及IVUS测得的斑块负荷呈正相关(r值分别为0.43、0.56,均P＜0.05). 结论 HMGB1和MPO与冠脉狭窄程度呈正相关,可作为判断ACS病情严重程度的预测指标；HMGB1和MPO与斑块的不稳定及破裂关系密切.
목적 연구고천이솔족단백1 (HMGB1)、수과양화물매(MPO)재예측관상동맥(관맥)병변정도화죽양경화역손반괴파렬중적작용. 방법 대50례급성심기경사(AMI)、50례불은정형심교통(UAP)급50례은정형심교통(SAP)환자분별진행관맥조영(CAG)화선택성혈관내초성(IVUS)검사이판단관맥관강협착정도、반괴성질급반괴파렬화혈전형성정황.30례CAG정상적환자위대조조.매련면역흡부법(ELISA)검측4조환자혈청HMGB1화MPO적수평,투시면역법측정고민C-반응단백(hsC-RP)수평.Gensini평분분석관맥병변정도,상관성분석판단HMGB1、MPO급hsC-RP여IVUS결과화Gensini평분적관계. 결과 AMI화UAP조적HMGB1、MPO급hsCRP혈청수평고우SAP조화대조조(균P＜0.01),AMI조고우UAP조(P＜0.05).IVUS결과현시AMI화UAP조주요위지질성반괴,분별위51.3 ％(20/39)화46.7％(43/92),이SAP조주요위섬유성반괴,지질반괴부점17.2％(15/87).여SAP조비교,AMI화UAP조반괴부하화혈관중구지수증대(균P＜0.01).AMI조HMGB1、MPO수평분별여Gensini평분급IVUS측득적중구지수정정상관(r치분별위0.54、0.48,균P＜0.05),UAP조HMGB1、MPO분별여Gensini평분급IVUS측득적반괴부하정정상관(r치분별위0.43、0.56,균P＜0.05). 결론 HMGB1화MPO여관맥협착정도정정상관,가작위판단ACS병정엄중정도적예측지표；HMGB1화MPO여반괴적불은정급파렬관계밀절.
Objective To elucidate the roles of high mobility group box-1 protein (HMGB1) and myeloperoxidase (MPO) deficiency in evaluating coronary stenosis and the vulnerability of atherosclerotic plaques in patients with coronary heart disease.Methods Totally 50 patients with acute myocardial infarction (AMI),50 patients with unstable angina pectoris (UAP),50 patients with stable angina pectoris (SAP) and 30 patients without coronary heart disease underwent the study.Coronary arteriography (CAG) and intravascular ultrasound (IVUS) were performed to analyze coronary stenosis and plaque characteristics and then gensini score was calculated.Concentrations of HMGB1,MPO and hypersensitive C reactive protein (hsC-RP) were measured by means of enzymelinked-immonosorbent assay (ELISA).Results Concentrations of HMGB1,MPO and hsC-RP were significantly higher in AMI and UAP patients than in SAP paticnts (all P＜ 0.01).IVUS showed that 51.3 ％ (20/39) AMI patients,46.7％ (43/92) UAP patients had soft lipid-rich plaqucs,while 52.9％(46/87) SAP patients had fibrous plaques,only 17.2％(15/87) had soft plaques.AMI and UAP patients had larger plaque burden and vascular remodeling index than did the SAP patients (both P＜0.01).In AMI group,HMGB1 and MPO levels were correlated well with gensini score and remodeling index measured by IVUS,respectively(r=0.54,0.48,allP＜0.05),while in UAP group,HMGB1 and MPO levels were correlated well with gensini score and plaque burden measured by IVUS,respectively(r=0.43,0.56,all P＜0.05).Conclusions HMGB1 and MPO are positively correlated with coronary stenosis,which can be used to predict the severity of ACS.HMGB1 and MPO are associated closely with plaque vulnerability and rupture.