CAJ | 학술논문

目的探讨老年冠心病患者血清高迁移率族蛋白B1(HMGB1)水平与冠状动脉病变程度及与预后的关系. 方法依据冠脉造影检查冠脉狭窄≥50％确诊为冠心病组180例,再按照病变严重程度分为单支、双支、三支组,冠脉造影未见狭窄者为对照组50例.根据改良Gensini评分将冠脉的狭窄程度分为轻度、中度、重度狭窄3组,依据超声心动的左心室射血分数减低程度将患者分为左心室收缩功能轻度、中度、重度功能障碍3组,所有患者均检测血清HMGB1、超敏C反应蛋白(hs CRP)、血糖指标,按是否并发糖尿病分为并发糖尿病组和未并发糖尿病组,并将冠心病患者分为不良事件组和非不良事件组,比较2组的上述指标. 结果冠心病组HMGB1水平三支组(40.5±6.0)μg/L,双支组(33.1±4.9)μg/L,单支组(20.5±3.3)μg/L,均高于对照组(6.2±1.4)μg/L(均P＜0.05),且HMGB1水平随血管狭窄严重程度而升高[重度狭窄组(43.0±5.8) μg/L,中度狭窄组(32.1±4.5)μg/L,轻度狭窄组(19.3±2.0)μg/L,均P＜0.05],HMGB1水平随左心室射血分数下降而升高(均P＜0.05),并发糖尿病组HMGB1水平(35.7±5.0)μg/L高于未并发糖尿病组(23.3±3.0)μg/L(P＜0.05),不良事件组血清HMGB1水平(38.7±5.5)μg/L高于非不良事件组(25.3±3.3)μg/L(P＜0.05),且HMGB1与hs-CRP、血糖呈正相关(r值分别为0.680、0.571),差异均有统计学意义(均P＜0.05). 结论血清HMGB1水平变化与老年冠心病的病变程度相关,且与冠心病患者的预后密切相关,作为一种新型的晚期炎症因子将为疾病的治疗提供新的靶点.
목적 탐토노년관심병환자혈청고천이솔족단백B1(HMGB1)수평여관상동맥병변정도급여예후적관계. 방법 의거관맥조영검사관맥협착≥50％학진위관심병조180례,재안조병변엄중정도분위단지、쌍지、삼지조,관맥조영미견협착자위대조조50례.근거개량Gensini평분장관맥적협착정도분위경도、중도、중도협착3조,의거초성심동적좌심실사혈분수감저정도장환자분위좌심실수축공능경도、중도、중도공능장애3조,소유환자균검측혈청HMGB1、초민C반응단백(hs CRP)、혈당지표,안시부병발당뇨병분위병발당뇨병조화미병발당뇨병조,병장관심병환자분위불량사건조화비불량사건조,비교2조적상술지표. 결과 관심병조HMGB1수평삼지조(40.5±6.0)μg/L,쌍지조(33.1±4.9)μg/L,단지조(20.5±3.3)μg/L,균고우대조조(6.2±1.4)μg/L(균P＜0.05),차HMGB1수평수혈관협착엄중정도이승고[중도협착조(43.0±5.8) μg/L,중도협착조(32.1±4.5)μg/L,경도협착조(19.3±2.0)μg/L,균P＜0.05],HMGB1수평수좌심실사혈분수하강이승고(균P＜0.05),병발당뇨병조HMGB1수평(35.7±5.0)μg/L고우미병발당뇨병조(23.3±3.0)μg/L(P＜0.05),불량사건조혈청HMGB1수평(38.7±5.5)μg/L고우비불량사건조(25.3±3.3)μg/L(P＜0.05),차HMGB1여hs-CRP、혈당정정상관(r치분별위0.680、0.571),차이균유통계학의의(균P＜0.05). 결론 혈청HMGB1수평변화여노년관심병적병변정도상관,차여관심병환자적예후밀절상관,작위일충신형적만기염증인자장위질병적치료제공신적파점.
Objective To investigate the correlation of serum high-mobility group box-1 (HMG-B1) with the severity of lesion of coronary artery disease (CAD) and its prognosis in elderly patients.Methods A total of 180 CAD patients with coronary stenosis exceeding 50 percent by coronary angiography were divided into three groups:one branch stenosis;two branches stenosis and three branches stenosis.The control group included 50 patients without coronary stenosis.The degrees of coronary stenosis were diagnosed as mild stenosis,moderate stenosis and severe stenosis based on improved Gensini scores.The severity of decrements of left ventricular ejection fraction (LVEF) by echocardiogram were divided into three groups:mild,moderate and severe LVEF.Levels of HMGB1,hs-CRP and glucose were measured in all the patients.According to whether there was a complication of type 2 diabetic mellitus (T2DM),the 180 patients were classified as two groups.The patients were also divided into two groups according to whether there were adverse events.Results The HMGB1 levels of the CAD group were increased along with the number of affected vessels [three bunch group (40.5±6.0) ng/ml,double bunch group (33.1±4.9)μg/L,single bunch group (20.5±3.3)μg/L and control group (6.2±1.4)μg/L (all P＜0.05)].And the HMGB1 levels of the CAD group were increased along with the degrees of CAD stenosis [severe stenosis group (43.0±5.8)μg/L,medium stenosis group (32.1±4.5)μg/L,mild stenosis group(19.3±2.0)μg/L] (all P＜0.05).Meanwhile,the levels of HMGB1 were increased along with the decrement of left ventricular ejection fraction [left ventricular severe dysfunction group (41.0 ± 5.5) μg/L,medium dysfunction group(33.1± 4.3)μg/L,mild dysfunction group (21.3± 2.0)μg/L] (all P＜0.05).CAD with T2DM had a higher HMGB1 level than non-T2DM group[(35.7±5.0) (C)/L vs.(23.3±3.0) (C)/L,P＜0.05].The adverse events group had a higher HMGB1 level than non-adverse events group[(38.7±5.5) (C)/L vs.(25.3±3.3)μg/L,P＜0.05].Besides,HMGB1 had a positive correlation with levels of hs-CRP and glucose(r=0.680,0.571,P＜0.05).Conclusions Serum HMGB1 change is closely related to morbid change degree of elderly CAD patients as well as prognosis.As a new type of inflammatory factor,HMGB1 may serve as a new target for disease treatment.