冠心病患者核因子-KB与血管细胞粘附分子-1的变化及其相关性

发布时间：2018-01-02 06:38

本文关键词：冠心病患者核因子-KB与血管细胞粘附分子-1的变化及其相关性　出处：《宁夏医科大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的:冠心病的发生与斑块的稳定性和继发血栓形成密切相关，于是人们开始意识到炎症介导的斑块破裂是冠心病发生的重要机制，可溶性血管细胞间粘附因子(sVCAM-1)是较有潜力且研究较多的一种炎性标志物，参与多种炎症及免疫过程，核因子-KB是调控炎性细胞基因表达的主要转录因子，，二者均参与急性冠脉综合征发生的病理过程，但二者的关系文献少有报道。本研究探讨冠心病患者外周血单核细胞核因子-KB(NF-KB)活性与血浆可溶性血管细胞粘附分子-1(sVCAM-1)水平的变化及其相关性,在冠心病发生发展和病情变化的预测价值。方法:采用ELISA方分别测定法76例冠心病患者，其中包括22例急性心肌梗死(AMI)34例不稳定型心绞痛(UAP)20稳定型心绞痛(SAP)患者和20例健康对照组血浆sVCAM-1和NF-KB浓度,采用免疫组化染色检测上述患者的外周血单核细胞NF-KBp65的表达同时记录测定血脂各指标参数包括甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等。记录所有研究对象的吸烟史、高血压病(EH)、糖尿病(DM)以及相关家族史(FH)，对所得参数进行统计学分析。结果:AMI组、UAP组外周血浆sVCAM-1NF-κB的浓度及外周血单核细胞NF-KB的活性均高于正常对照组,差异均有统计学意义(P＜0.05) SAP组与正常组比较无明显差异(P＞0.05) AMI组、UAP组NF-KB、sVCAM-1表达均高于SAP组，AMI组NF-KB、sVCAM-1表达明显高于UAP组(P＜0.05)且外周血单核细胞NF-kB与sVCAM-1的水平呈显著正相关(r=0.657,P=0.009)。作为冠心病的危险因素，冠心病组的吸烟史TC水平以及合并高血压病的人数明显高于对照组（P＜0.05)以冠心病为因变量,年龄性别糖尿病史高血压病史血脂等作为自变量,进行多元Logistic逐步回归分析(入选变量显著性水准为α=0.05),表明吸烟TC高血压均为冠心病患病的独立危险因素结论:NF-KB sVCAM-1均与动脉粥样硬化斑块稳定性密切相关,且二者均参与了冠心病的发生发展。sVCAM-1可能通过促进NF-KB的活化而导致各种促动脉粥样硬化的细胞因子和趋化因子的生成,最终促使ACS的发生NF-KB作为引发炎症的关键转录因子可能上调sVCAM-1的表达
[Abstract]:Objective : The occurrence of coronary heart disease is closely related to the stability of plaque and the formation of secondary thrombosis , so it is becoming aware that inflammation - mediated plaque rupture is an important mechanism for coronary heart disease . The soluble vascular cell adhesion factor ( sVCAM - 1 ) is the main transcription factor that regulates the expression of inflammatory cell gene . Both of them are involved in the pathological process of acute coronary syndrome . Both of them are involved in the pathogenesis of acute coronary syndrome . Methods : Serum sVCAM - 1 and NF - KB were measured by ELISA in 76 patients with coronary heart disease , including 22 acute myocardial infarction ( AMI ) , 34 unstable angina pectoris ( UAP ) 20 stable angina pectoris ( SAP ) patients and 20 healthy controls . The parameters including triglyceride ( TG ) , total cholesterol ( TC ) , high density lipoprotein cholesterol ( HDL - C ) and low density lipoprotein cholesterol ( LDL - C ) were measured by immunohistochemistry . All study subjects were recorded with smoking history , hypertension , diabetes mellitus ( DM ) and related family history ( FH ) , and the parameters were analyzed statistically . Results : The levels of sVCAM - 1NF - 魏B and NF - KB in peripheral blood mononuclear cells were significantly higher in AMI group than in normal control group ( P < 0.05 ) . The expression of NF - KB and sVCAM - 1 in AMI group was significantly higher than that in SAP group ( P < 0.05 ) . The expression of NF - KB and sVCAM - 1 in UAP group was significantly higher than that in SAP group ( P < 0.05 ) . As a risk factor for coronary heart disease , the TC level of smoking history and the number of patients with hypertension were significantly higher than those in the control group ( P < 0 . 05 ) . Conclusion : NF - KB sVCAM - 1 is closely related to the stability of atherosclerotic plaque , and both are involved in the development of coronary heart disease . sVCAM - 1 may contribute to the formation of various cytokines and chemokine by promoting the activation of NF - KB , which may eventually lead to the expression of NF - KB as a key transcription factor to trigger inflammation and possibly up - regulate the expression of sVCAM - 1 .

【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R541.4

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