| Objective: Vulnerable plaque is an important factor of acute coronary events.In recent years,studies have found that inflammatory reaction and the complement activation process involved in the formation of vulnerable plaques.This article observes the changes of serum complements and inflammatory factors in NSTE-ACS patients.Purpose is to understand the inflammatory response and complement to the influence of the NSTE-ACS,and to evaluate prognosis of NSTE-ACS patients.Methods: 72 NSTE-ACS patients adminited to cardiovascular department in Tianjin Union Medical Center from December 2012 to July 2014 were included.The diagnoses of patients were established according to the guideline of ACC and AHA published NSTE-ACS diagnostic criteria in 2014.33 healthy subjects were selected as control group in medical examination center of the same hospital.It was measured the levels of C3,C4,C5b-9,hs-CRP,s ICAM-1 and other biochemical indicators.Results:1.The level of C3,C4 and C5b-9,hs-CRP and s ICAM-1 in NSTE-ACS patients was higher than that of control group cases,and the difference was statistically significant(P < 0.05).Serum complements and inflammatory factors levels rose in patients with NSTE-ACS.2.The change trend of serum complement levels after the first rise in decline by continuously observed C3,C4 and C5b-9 in patients with NSTE-ACS.And C3,C4 and C5b-9 was its peak in the third day.The complement system is activated in the acute phase of NSTE-ACS.3.The correlation analysis of complements C3,C4,C5b-9,inflammatory factor s ICAM-1with myocardial enzyme(Tn T,CKMB),LVEF and NT-pro BNP in patients with NSTE-ACS found that C3,C4 and myocardial enzymes were positively correlated(P < 0.05),and negatively correlated with LVEF(P < 0.05),that complement C5b-9 and Tn T were positively correlated(P < 0.05),and no obvious correlation between CKMB and cardiac function(P > 0.05),and that SICAM-1 and myocardial enzymes were positively correlated,no obvious correlation with cardiac function(P > 0.05).4.For patients with NSTE-ACS,C3,C4 and Tn T,CKMB level increased significantly in hs-CRP high-risk group than in low-risk group,and the difference was statistically significant(P < 0.05).LVEF reduced significantly in high-risk group than in low-risk group,and the difference was statistically significant(P < 0.05).No significant statistical differences of C5b-9,s ICAM-1 and NT-pro BNP was found between high-risk and low-risk group(P > 0.05).5.Patients with NSTE-ACS were divided into low-risk group,intermediate-risk group,and high-risk group according to GRACE score.Serum C3、C4 and s ICAM-1 increased following with the rise of risk stratification,and the differences were statistically significant(P < 0.05).C3,C4,s ICAM-1,and hs-CRP were significantly higher in high-risk group than in the combined group with intermediate-risk group and low-risk group(P < 0.05).Conclusion: 1.Inflammatory reaction and the activation of the complement occur in patients with NSTE-ACS,and transiently increased in the acute phase of NSTE-ACS.2.In patients with NSTE-ACS,peak levels of serum C3 and C4 were positively correlated with those of Tn T and CKMB,while negatively correlated with LVEF,which was supposed that complement level was closely related to the cardiac function in patients with NSTE-ACS.3.C3,C4,Tn T and CKMB levels elevated obviously in patients of hs-CRP high-risk group,while LVEF dropped significantly,which showed under difference hs-CRP risk stratifications serum complement activation degree,myocardial damage degree and degree of impaired cardiac function were difference.4.Inflammatory factors and C3,C4 were significantly higher in high-risk group than in the combined group with intermediate-risk group and low-risk group.The levels of inflammatory factors and complements in the acute phase of NSTE-ACS could predict the prognosis of patients of NSTE-ACS. |
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