急性冠脉综合征患者血清高迁移率族蛋白B1 的表达及阿托伐他汀干预治疗的影响

摘要： 目的 探讨急性冠脉综合征 （ACS） 患者血清高迁移率族蛋白 B1 （HMGB1） 及超敏 C 反应蛋白 （hs-CRP） 的表达及阿托伐他汀干预治疗对其影响。方法 选择临床确诊为 ACS 的患者 90 例和对照组 90 例， 所有患者均于治疗前抽取空腹肘正中静脉血， 检测 HMGB1 及 hs-CRP； 将 ACS 组患者按随机数字表法分为标准组 （45 例） 和强化组（45 例）， 分别给予阿托伐他汀 20 mg 每天 1 次和 40 mg 每天 1 次， 治疗 1 周后再次抽取空腹肘正中静脉血， 检测 HMGB1 及 hs-CRP。结果 ACS 组患者血清 HMGB1 及 hs-CRP 水平高于对照组 （P＜0.01）。ACS 组患者血清 HMGB1 水平与 hs-CRP 水平呈正相关 （r= 0.389， P＜0.01）。治疗前， 标准组与强化组患者血清 HMGB1 及 hs-CRP 基线水平差异无统计学意义； 治疗后 1 周， 2 组患者血清 HMGB1 及 hs-CRP 水平较治疗前均降低， 且强化组较标准组降低更明显 （均 P＜0.05）。结论 HMGB1 和 hs-CRP 相互影响， 在动脉粥样硬化的发生、 发展中发挥重要作用。强化阿托伐他汀治疗能显著降低 HMGB1 表达， 减轻ACS 患者的炎症反应， 稳定冠脉粥样硬化斑块。

The expression of high mobility group box-1 in patients with acute coronary syndrome and the treatment of atorvastatin

Abstract: Objective To investigate the expressions of high mobility group box-1(HMGB1) and high sensitivity C-re⁃ active protein (hs-CRP) in patients with acute coronary syndrome (ACS) and the effects of atorvastatin on the two inflamma⁃ tory cytokines. Methods A total of 90 patients with ACS and 90 cases of normal control subjects were selected in this study. The serum concentrations of HMGB1 and hs-CRP were measured before treatment in patients of ACS. Patients were randomly divided into two groups: control group (n=45) and atorvastatin group (n=45). Atorvastatin was given 20 mg/24 h and 40 mg/24 h. Blood samples were obtained from the patients for detection of HMGB1 and hs-CRP one week after treatment with atorvastatin. Results There were significantly higher serum levels of HMGB1 and hs-CRP in patients with ACS than those of control subjects (P＜0.01). The level of HMGB1 was positively correlated with the level of hs-CRP in patients of ACS (r=0.389, P＜0.01). Before treatment, there were no significant diffferences in level of HMGB1 and hs-CRP in patients with ACS between the two groups. After treatment with atorvastatin, the levels of HMGB1 and hs-CRP were decreased in the two groups of ACS, and those were significantly lower in the intensive group than the standard group (P＜0.05). Conclu⁃ sion HMGB1 could stimulate the secretion of hs-CRP and other inflammatory cytokines, playing an important role in the process of occurrence and development of atherosclerosis. High loading dose of atorvastatin may reduce the expression of HMGB1 and decrease the inflammation, and stabilize the plaques in patients with acute coronary syndrome.