| Objective To investigate the changes and the clinical insignificance of nuclear factor kappaB(NF-κB) activation in the peripheral blood mononuclear cells(PBMC) of patients during the different pathogenetic stages of the various type of coronary heart disease (CHD). In order to illuminate it's role in the development of CHD and to provide the theoretical evidence for whether it can be used as one of the main prognosticate indexes for the development of the coronary artery diseases.Methods Total 90 patients with CHD coincidence with the testing standard is classified three groups: acute myocardial infarction(AMI) group(30patients), unstable angina (UA) group(30patients), stable angina(SA) group(30patients); In addition, 30 normal persons confirmed by coronary angiography(CAG)as control (Ctrl)group. Each group collects 2ml venous blood in the EDTA anticoagulation test tubes at 1, 3 and 7 days after admission respectively. NF-κB activation in PBMC is detemined quantificationally by flow cytometer with the NF-κB Kit. To analysis the NF-κB activation in different groups and different stages and the relations between the NF-κB activation and their clinical characteristic and complications. The clinical symptoms the main angiocardiac events(MACE) (including cardiac death,recurrent AMI,once more revascularization etc) are observed during their hospitalization and the 3-6 months'follow-up after discharge.Result1. There is no difference in age, sex, total cholesterol(TC), high density lipoprotein cholesterol(HDL) and low density lipoprotein cholesterol(LDL)(P>0.05). The patients of coronary heart diseases have more risk factors such as the history of hepertension and/or diabete,the family history of cardial-cerebrovescular diseases,smoking than Ctrl group(P<0.001).The level of body mass index(BMI), blood glucose in AMI group and UA group are much higher than those in SA group and Ctrl group(P<0.05).The cardial and renal function in both AMI group and UA group and the hepatic function in AMI group are worse than the Ctrl group(P<0.05).2. The activity of NF-κB in PBMC in AMI group for the three times after admission is significantly higher than that in the other three groups(P<0.001). And that in UA group at 1 and 3 days is remarkably higher than that in SA group and Ctrl group(P<0.001), but there is no difference at 7 days(P>0.05). The activity of NF-κB in PBMC in SA group for the three times is higher than that in Ctrl group, but there is no statistic significance(P>0.05). The activity of NF-κB in AMI group and UA group is gradually reduced with the time in hospital, which is much less at 7 days than at 1 and 3 days(P<0.01), but there is no statistic significance between 1 and 3 days(P>0.05). There is no changes for the NF-κB activation in SA group and Ctrl group for the three times after admission(P>0.05).3. There are no relations between the NF-κB activation of the first day after admission and TnI,CK or CK-MB at the same time(P>0.05). There is positive relation between the NF-κB activation of the seventh day after admission and the left ventricular end-diastolic diameter(LVEDD) (r=0.439, P=0.015).4. During the follow-up for 3-6 months, in AMI group 1 case recur myocardial infarction and death; 2 cases break out angina several times and hospitalization again for PCI. In UA group 1 case recur angina and restenosis inside the stent by CAG for PCI again.Conclusion1. The NF-κB activation is closely bound up with the serious degrees of the pathological changes in CHD and shows a certain regularity followed by the changes of patients'conditions .2. NF-κB may takes part in the process of the ventricle reconstitution after AMI.3. the changes of NF-κB activation can be relavant to the prognosis of CHD.4. it can be used for the criticality estimation of CHD. And it is one of the main prognosticate indexes for the development of the coronary artery diseases. |
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