ST段抬高性AMI患者血浆高迁移率族蛋白B1浓度的变化

目的:揭示ST段抬高性急性心肌梗死(STEAMI)患者血浆高迁移率族蛋白B1浓度的变化,探讨其临床意义。方法:收集STEAMI患者110例、健康体检者50例(作为对照组)。对照组静脉血体检时获得。STEAMI患者静脉血在入院时、入院后第1、2、3、5和7d获得。ELISA测定血浆高迁移率族蛋白B1浓度。结果:STEAMI患者住院期间主要不良心脏事件发生30例(27.3%)。STEAMI患者血浆高迁移率族蛋白B1浓度显著升高,1d内到达高峰,后逐渐下降,均显著地高于对照组(P<0.01)。在各个时间点,住院期间主要不良心脏事件发生患者血浆高迁移率族蛋白B1浓度均显著高于住院期间主要不良心脏事件不发生患者(P<0.05)。ROC曲线显示血浆高迁移率族蛋白B1浓度预测住院期间主要不良心脏事件发生有显著意义(曲线下面积=0.836,95%CI=0.776～0.873,P<0.01),且判定入院时血浆高迁移率族蛋白B1浓度>13.6 ng/ml,对预测住院期间主要不良心脏事件发生有80.0%的灵敏度和75.0%的特异度。结论:STEAMI患者血浆高迁移率族蛋白B1浓度显著升高,临床检测这个指标有助于早期判断STEAMI患者住院期间主要不良心脏事件的发生。

Change of Plasma High Mobility Group Box 1 Protein Concentration in Patients with ST-Segment Elevation Acute Myocardial Infarction

Objective In this study,serial changes of plasma high mobility group box 1 protein levels were determined in patients with ST-segment elevation acute myocardial infarction(STEAMI) and its correlation with major adverse cardiac event(MACE) was evaluated.Methods 110 consecutive patients with STEAMI and 50 age-and sex-matched healthy controls were enrolled into this study.Plasma samples were obtained on entry in healthy controls,as well as on admission at days 1,2,3,5 and 7 after in patients with STEAMI.Its concentration was measured by ELISA.Results 30 patients(27.3%) suffered from MACE.After STEAMI,plasma high mobility group box 1 protein level in the patients statistically remarkably increased on admission,peaked at day 1,decreased thereafter(all P<0.01).At each time,plasma high mobility group box 1 protein levels of patients with MACE were statistically significantly higher than those in patients with without MACE(all P<0.05).A receiver operating characteristic curve identified cutoff value of plasma high mobility group box 1 protein level(13.6ng/ml) that predicted MACE of patients with the high sensitivity(80.0%) and specificity values(75.0%).Conclusion Increased plasma high mobility group box 1 protein level is found after STEAMI,in association with MACE in hospital.Detecting of this biomarker might be helpful to predict heart attacks earlier during hospitalization.