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目的探讨冠心病患者血浆高迁移率蛋白B1(high-mobility group box 1protein,HMGB1)与冠心病病变程度和斑块易损性的相关性。方法冠状动脉造影异常患者73例,其中急性冠状动脉综合征(acute coronary syndrome,ACS)患者45例(ACS组)和稳定型心绞痛(stable angina pectoris,SAP)患者28例(SAP组);根据冠状动脉狭窄程度Gensini积分四分位数又分为低积分组17例(Gensini积分≤17.0)、中积分组16例(Gensini积分>17.0~49.1)、高积分组24例(Gensini积分>49.1~73.2)、极高积分组16例(Gensini积分>73.2)。检测各组血浆HMGB1水平,分析血浆HMGB1水平与冠状动脉狭窄程度间关系。患者均于冠状动脉造影术后行血管内超声检查,比较各组冠状动脉斑块显像参数特征及HMGB1水平与斑块构成间关系。结果极高积分组血浆HMGB1水平[(5.68±0.21)μg/L]明显高于高积分组[(4.76±0.15)μg/L]、中积分组[(4.08±0.25)μg/L]和低积分组[(3.62±0.19)μg/L](P<0.05),高积分组高于中积分组和低积分组,中积分组高于低积分组(P<0.05);ACS组管腔面积[(5.32±2.71)mm2]和冠状动脉斑块纤维帽厚度[(0.75±0.14)mm]明显小于SAP组[(6.79±2.31)mm2、(0.81±0.11)mm](P<0.05),偏心指数(0.67±0.21)、斑块负荷[(64.70±9.98)%]、重构指数(1.12±0.31)和斑块面积[(11.48±3.34)mm2]明显大于SAP组[0.50±0.08、(52.12±8.17)%、0.79±0.14、(9.96±3.16)mm2](P<0.05),血管外弹力膜面积[(15.98±3.69)mm2]与SAP组[(15.36±3.12)mm2]比较差异无统计学意义(P>0.05);ACS组HMGB1水平与重构指数和偏心指数呈正相关(r=0.378,P=0.031;r=0.311,P=0.026),与纤维帽厚度呈负相关(r=-0.297,P=0.041)。结论血浆HMGB1水平与冠状动脉病变程度及斑块易损性指标间有明显相关性。
Objective To investigate the relationship between plasma high-mobility group box 1 protein (HMGB1) and the severity of coronary heart disease and plaque vulnerability in patients with coronary heart disease. Methods Totally 73 patients with abnormal coronary angiography were enrolled, including 45 patients with acute coronary syndrome (ACS) and 28 patients with stable angina pectoris (SAP). According to coronary artery Arterial stenosis degree Gensini interquartile range was further divided into 17 low-score group (Gensini score≤17.0), 16 middle-score group (Gensini score> 17.0-49.1) and 24 high-score group (Gensini score> 49.1-73.2 ), And 16 in the high score group (Gensini score> 73.2). The level of plasma HMGB1 in each group was measured, and the relationship between plasma HMGB1 level and the degree of coronary artery stenosis was analyzed. Patients underwent intracoronary ultrasonography after coronary angiography. The parameters of coronary plaque imaging and the relationship between HMGB1 level and plaque constitution were compared. Results The level of plasma HMGB1 was significantly higher in the hyperkinetic group [(5.68 ± 0.21) μg / L] [(4.76 ± 0.15) μg / L] and [4.08 ± 0.25 μg / L] (3.62 ± 0.19) μg / L] (P <0.05). The high-score group was higher than the middle-score group and the low-score group, and the middle-score group was higher than the low-score group [(5.32 ± 2.71) mm2] and coronary artery plaque fibrin cap thickness [(0.75 ± 0.14) mm] were significantly lower than those in SAP group [(6.79 ± 2.31) mm2, (0.81 ± 0.11) mm] (0.67 ± 0.21), plaque burden (64.70 ± 9.98)%, remodeling index (1.12 ± 0.31) and plaque area [(11.48 ± 3.34) mm2] were significantly higher than those in SAP group [0.50 ± 0.08, (15.98 ± 3.69) mm2] compared with [(15.36 ± 3.12) mm2] in SAP group [(15.36 ± 3.12) mm2], P <0.05) (P> 0.05). The level of HMGB1 in ACS group was positively correlated with the remodeling index and eccentricity index (r = 0.378, P = 0.031; r = 0.311, 0.297, P = 0.041). Conclusion There is a significant correlation between the level of plasma HMGB1 and the severity of coronary artery disease and plaque vulnerability.