| Objective:To investigate the relationships between the changes in serum HMGB1,TNF-αand coronary artery lesions, cardiac function in patients with acute coronary syndrome(ACS).Methods:Select in March 2013- September 2014 in the first affiliated hospital of shihezi university of 60 patients. All examined patients underwent coronary angiography. Percutaneous coronary intervention in patients with ACS were picked out as test group(AMI group, n=30;UAP group,n=30), AMI group including twenty-two men and eight women whose average age was 54.77±10.09, UAP group including twenty-one men and nine women whose average age was 59.63±9.97. The degree of coronary artery lesions was assessed by the number of coronary artery lesions and Gensini integral. Meanwhile, the patients undergoing coronary angiography without any artery lesions were as control group(n = 30), including twenty men and ten women whose average age is 54.07±11.07. Serum levels of HMGB1 and TNF-αwere measured by enzyme-linked immunosorbent assay(ELISA) both before and after the standardized hospitalization as well as in 30 controls; Left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD) and Left ventricular fractional shortening(FS) were measured by echocardiography.Results:(1)Serum levels of HMGB1(AMI group: 33.22±16.59 ng/m L, UAP group: 23.40±12.17 ng/m L)and TNF-α(AMI group: 10.68±4.94 pg/m L, UAP group: 6.37±3.53 pg/m L) in patients with ACS before the standardized hospitalization were significantly higher than that of control group(HMGB1: 12.23±2.74ng/m L; TNF-α: 2.13±1.26 pg/m L)(P < 0.01). Compared with AMI group, serum HMGB1 and TNF-αlevels in UAP group were significantly reduced before treatment(P<0.01).(2)The levels of HMGB1(AMI group: 21.67±13.00 ng/m L, UAP group: 18.71±6.92 ng/m L) and TNF-α(AMI group: 5.28±3.09 pg/m L, UAP group: 3.71±2.34 pg/m L) in patients with ACS after the standardized hospitalization were lower than before(P<0.05).(3)Serum levels of HMGB1 from different numbers of coronary artery lesion in ACS patients were: single-lesion: 13.45±4.48 ng/m L, double-lesions: 27.39±15.22 ng/m L, multi-lesions: 40.79±18.51ng/m L); Serum levels of HMGB1 from different stenosis degree were: mild: 14.91±6.18 ng/m L, moderate:29.63±21.81 ng/m L, severe: 41.74±10.37 ng/m L; The differences between groups were statistically significant(P<0.05).(4)Compared with control group, LVEF in patients with ACS was lower(P<0.01),FS was lower(P<0.05),but LVEDD wasn’t significant difference.(5) Correlation analysis showed that serum level of HMGB1 was positively correlated with coronary artery lesion counts, coronary artery lesion Gensini integral(r=0.525,P<0.01;r=0.588,P<0.01), whereas was negatively correlated with LVEF(r=-0.488,P<0.01)in patients with ACS.Moreover,the level of TNF-αwas positively correlated with HMGB1(r=0.415, P<0.01).Conclusion:(1) Serum HMGB1 and TNF-αlevels were gradually increased in UAP group、AMI group before the standardized hospitalization, and which were significantly higher than that of control group. While, the levels of the both in patients with ACS after the standardized hospitalization were decreased than before, which suggested that elevated levels of the both may be involved in the origination and development of ACS.(2) Serum level of HMGB1 was positively correlated with coronary artery lesion counts, coronary artery lesion Gensini integral, whereas was negatively correlated with LVEF in patients with ACS. Moreover, the level of TNF-αwas positively correlated with HMGB1. The present findings suggested that Serum levels of the both may be used as indicator to conjecture the severity degree of coronary artery lesion in patients with ACS. |
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