冠心病患者外周血单核细胞表面晚期糖基化终末产物受体水平的表达  

Expression of Receptor for Advanced Glycation Endproduct on Peripheral Blood Mononuclear Cells in Patients with Coronary Heart Disease

作　　者：周鹤[1] 牛楠[1] 曲鹏[1] 解丽颖[1] 杨丽[1] 

机构地区：[1]大连医科大学附属第二医院心内科,辽宁省大连市116027

出　　处：《中国动脉硬化杂志》2013年第3期262-266,共5页Chinese Journal of Arteriosclerosis

摘　　要：目的探讨外周血单核细胞表面晚期糖基化终末产物受体(RAGE)的表达水平与冠心病患者临床表现及冠状动脉病变严重程度的关系,并评估其对冠心病患者风险的预测价值。方法选择因胸痛住院并行冠状动脉造影的患者80例,据其不同临床表现、冠状动脉病变的Gensini积分、病变血管支数进行相应分组,采用流式细胞学方法测定外周血单核细胞表面RAGE水平。结果急性心肌梗死组、不稳定型心绞痛组外周血单核细胞表面RAGE表达水平均高于稳定型心绞痛组和对照组(P<0.01)。RAGE水平与高敏C反应蛋白水平呈正相关(r=0.476,P=0.01);多支病变组和两支病变组外周血单核细胞表面RAGE表达水平高于单支病变组(P<0.05);多支病变组RAGE水平高于两支病变组(P<0.05);根据冠状动脉造影Gensini评分分为三组,三组间外周血单核细胞表面RAGE水平逐渐升高,且各组间差异均具有统计学差异。外周血单核细胞表面RAGE水平与冠状动脉造影评分之间呈正相关(r=0.376,P=0.007);采用Logistic回归法分析高水平的外周血单核细胞表面RAGE水平是冠心病患者发生急性冠状动脉综合征的独立危险因素(OR=1.180,P=0.02)。结论冠心病患者外周血单核细胞表面RAGE表达水平明显增加,且随着临床表现严重程度的增加呈逐渐升高趋势,对冠心病患者的临床表现有预测价值。外周血单核细胞RAGE水平与冠状动脉病变狭窄程度相关,对冠状动脉病变严重程度有一定的预测价值。高水平外周血单核细胞RAGE的表达是冠心病患者临床表现严重程度的独立危险因素。Aim To analyze the relationship between the level of receptor for advanced glycation endproducts （RAGE） on peripheral blood mononuclear cells （PBMC） and the clinical manifestations of coronary heart disease and the severity of angiographic lesion. Further investigation should be made to discuss whether RAGE can play a guiding role in the prediction and assessment of the risk of coronary heart disease. Methods 80 study participants were scheduled to undergo elective cardiac catheterization for suspected coronary artery disease according to clinical manifestations of coronary heart disease, Gensini scores of coronary angiographic stenosis and the number of diseased coronary artery, all subjects were divided into different groups. Expression of RAGE on PBMC was detected by flow cyto-metric analysis. Results RAGE of PBMC level of patients with AMI group and UAP group were apparently higher than those in the SAP group and control group （P 〈 0.01 ）. RAGE level was positively correlated with hs-CRP level （ r = O. 476, P = O. 01 ） ; the RAGE level of PBMC gradually increased. RAGE in muti-vessel CAD group was higher than that in single-vessel CAD group and double-vessel CAD group （ P 〈 0. 05 ）. RAGE in double-vessel CAD group was higher than that in single-vessel CAD group （P 〈 0.05）. The level of RAGE of PBMC gradually increased with the Gensini score exaltation. Statistic differences existed among groups. Both the level of RAGE showed positve correlation to Gensini score （ r = O. 376, P = O. 007）. Logistic regression analysis showed that high level of RAGE was the independent risk factor of the severity of clinical manifestation in patients with coronary heart disease （ OR = 1.180,P = 0. 02）. Conclusion The RAGE level on PBMC increases significantly in patients with coronary artery disease and is in positive correlation with the severity of clinical manifestation of coronary heart disease. The RAGE level on PBMC is correlated with coronary artery lesion. It is of certain value on p

关 键 词：晚期糖基化终末产物 冠心病 外周血单核细胞 

分 类 号：R5[医药卫生—内科学]