冠心病患者心外膜脂肪体积及脂肪组织基质蛋白酶2表达、磷脂酶A_2水平及意义  

Epicardial adipose tissue volume and MMP-2 and PLA_2 levels in epicardial adipose tissues of patients with coronary artery disease

作　　者：杜文涛[1] 白净[1] 智华[1] 

机构地区：[1]河北工程大学附属医院,河北邯郸056002

出　　处：《山东医药》2016年第12期24-27,共4页Shandong Medical Journal

摘　　要：目的检测冠心病患者心外膜脂肪体积(EATV)及心外膜脂肪组织基质蛋白酶2(MMP-2)表达、磷脂酶A_2(PLA_2)水平,分析其意义。方法选择行心脏手术患者113例,其中冠心病患者67例(冠心病组),心脏瓣膜病患者(瓣膜病组)46例。术前均行双源CT检查,测量EATV,评价冠状动脉斑块性质,判断是否发生血管正性重构;术中取心外膜脂肪组织及胸腔脂肪组织,检测脂肪组织MMP-2 mRNA、MMP-2蛋白表达及PLA_2水平。分析冠心病患者发生血管正性重构的影响因素。结果冠心病组EATV为(128.08±45.34)cm3、瓣膜病组为(84.21±25.37)cm3,两组发生血管正性重构者分别为36、10例,两组比较P均<0.01。冠心病组心外膜脂肪组织MMP-2 mRNA、MMP-2蛋白表达及PLA_2水平均明显高于瓣膜病组(P均<0.05),两组胸腔脂肪组织上述指标比较差异均无统计学意义(P>0.05)。EATV、MMP-2、PLA_2、高血压是冠心病患者发生血管正性重构的影响因素(P<0.05或<0.01)。结论冠心病患者EATV增大,心外膜脂肪组织MMP-2高表达、PLA_2水平增加;EATV、MMP-2、PLA_2是冠心病患者发生血管正性重构的影响因素。Objective To detect the content of epicardial adipose tissue volume（ EATV） and the levels of matrix metalloproteinase 2（ MMP-2） and phospholipase A_2（ PLA_2） in the epicardial adipose tissues of patients with coronary heart disease（ CHD） and to analyze the significance. Methods A total of 113 patients receiving thoracic surgery were collected,including 67 patients with coronary heart disease（ CHD group） and 46 cases with heart valve disease（ valvular disease group）. EATV and the nature of the plaque were detected by dual-source CT before surgery to determine whether vascular positive remodeling happened. Then,epicardial adipose tissue（ EAT） and intrathoracic adipose tissue（ TAT） were collected. MMP-2 mRNA and protein levels were detected by RT-PCR and Western blotting. The PLA_2 level was detected by ELISA. Finally,the factors related to vascular positive remodeling were analyzed by the logistic regression. Results The EATV in the CHD group was（ 128. 08 ± 45. 34） cm3,and（ 84. 21 ± 25. 37） cm3 in the valvular disease group. There were respectively 36 and 10 cases of vascular positive remodeling in the two groups（ all P〈0. 01）. The MMP-2 mRNA and protein expression levels,PLA_2 in EATV of the CHD group were significantly higher than those of the valvular disease group（ all P〈0. 05）,but the differences of the above indexes were not statistically significant in the thoracic adipose tissues（ all P〈0. 05）. EATV,MMP-2,PLA_2 and high blood pressure were the independent risk factors for the development of vascular positive remodeling in CHD patients. Conclusions The levels of EATV,MMP-2 and PLA_2 in the epicardial adipose tissues of CHD patients were increased. EATV,MMP-2 and PLA_2 were the independent risk factors for the development of vascular positive remodeling in CHD patients.

关 键 词：冠状动脉粥样硬化 基质金属蛋白酶2 磷脂酶A2 心外膜脂肪 血管正性重构 

分 类 号：R654.2[医药卫生—外科学]