| ObjectiveTo investigate the expressions of high mobility group box-1(HMGB1)? high sensitivity C-reactive protein(hs-CRP)and matrix metalloproteinase 9(MMP-9) in acute coronary syndrome(ACS)patients, researching the relationship between the three risk factors with ACS. Investigating the effects of loading dose of atorvastatin on the three risk factors in patients of ACS during PCI perioperative period and its clinical significance. Methods1?Select the 120 cases of patients with ACS and 106 cases of normal control subjects, all of patients of serum concentrations of HMGB1?hs-CRP and MMP-9 were measured before the therpy of interventional treatment and many biochemical indicators to be analyzed. Analyzing the difference of the serum levels of these risk factors among the different branches of coronary artery disease groups. To investigate the three risk factors for ACS and the relationship between them in ACS patients.2?The patients of ACS were randomly divided into two groups. In control group(n=60), atorvastatin 20 mg/d was given. In high dose atorvastatin group(n=60), atorvastatin 40 mg/d was given entail one month after PCI. Each group was given the same basic treatment. Blood samples were obtained from the patients with ACS 24 h and one week after the treatment of PCI, and the three risk factors were detected again. The adverse drug reactions were observed. Four weeks after the treatment of PCI the LVEF, LVEDD and the NT-proBNP were measured. About half of a year later, the major cardiovascular events incidence were observed in all patients with ACS. Results1?There were siginificantly higher serum levels of HMGB1, hs-CRP, MMP-9 and NT-proBNP in patients with ACS than those of control subjects(P<0.05); the serum levels of HMGB1, hs-CRP and MMP-9 remarkably increased with the severity of coronary artery disease(all P<0.05).2?The serum HMGB1 levels and hs-CRP levels were positively correlated ACS, high-density lipoprotein cholesterol(HDL-C) and the ACS was negatively correlated(all P <0.05); and the serum levels of HMBG1 and the serum levels of hs-CRP had a positive correlation in patients with ACS(?= 0.300, P <0.05).3?Before the treatment of PCI, there were no significant differences in HMGB1, hs-CRP and MMP-9 levels between two groups(P>0.05). 1 day after PCI, the levels of HMGB1, hs-CRP and MMP-9 in the two groups were increased obviously compared with baseline(all P<0.05), but they were no notable difference btween two group(all P>0.05). One week after PCI, the levels of HMGB1, hs-CRP and MMP-9 were decreased compared with such date 1 day after PCI. But they were still higher than baseline in the intensive group, and they were have no differ with baseline in the high dose group(all P>0.05).4?1 month after the treatment of PCI, all patients of two groups have higher LVEF, lower LVEDD and lower NT-proBNP than before PCI(all P<0.05),but they were no notable difference btween two group(all P>0.05).Six months later, the patients in the two groups have 3 cases and 8 cases of the major cardiovascular events incidence respectively(P<0.05). Conclusion1?The serum concentrations of HMGB1 were siginificantly increased in patients with ACS,and it has positive correlation with ACS, it may be the risk factors for ACS. HMGB1 could stimulate the secretion of hs-CRP, playing an important role in the process of occurrence and development of atherosclerosis and ACS.2?High loading dose of atorvastatin in patients with acute coronary syndrome underwent PCI may reduce the expression of HMGB1, decrease the inflammation more significantly and stabilize the plaques,and improve heart function in acute stage,and which is safe in short period. |
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