G蛋白耦联受体激酶2在急性冠状动脉综合征的调节及意义  

Adjustment and value of lymphocyte G protein-coupled receptor kinase-2 protein levels in patients with acute coronary syndrome

作　　者：葛庆玲 王清[2] 田秀青[2] 

机构地区：[1]山东省府机关医院内科,济南250000 [2]山东省千佛山医院心内科,250014

出　　处：《中国医师进修杂志》2016年第7期600-603,共4页Chinese Journal of Postgraduates of Medicine

基　　金：山东省科技攻关计划项目资助（2012YD18051）

摘　　要：目的：探讨G蛋白耦联受体激酶2（GRK2）在急性冠状动脉综合征（ACS）的调节及意义。方法选择稳定型心绞痛（SAP）患者42例、不稳定型心绞痛（UAP）患者44例、急性心肌梗死（AMI）患者43例和正常冠状动脉（NCA）患者46例，应用Western-blot检测外周血淋巴细胞GRK2表达，动态心电图分析心率变异性（HRV），心脏彩超测定心功能，比较各组检测结果，并对ACS患者GRK2水平与HRV指标和心功能指标进行相关性分析。结果 UAP组和AMI组GRK2水平分别为（165.6±60.2）%、（209.8±63.9）%，均显著高于SAP组的（131.7±51.8）%和NCA组的（125.3±50.6）%，并且在AMI组中表达最高，差异均有统计学意义（P＜0.01）。多元线性回归分析表明，ACS 患者 GRK2水平与高频（HF）、低频（LF）、LF/HF、正常心动周期的标准差（SDNN）、24 h内全部5 min节段所有心动周期标准差的平均值（SDNNI）及左室射血分数（LVEF）呈显著负相关（r=-0.52、-0.47、-0.53、-0.56、-0.49、-0.51，P＜0.01）。结论 ACS患者淋巴细胞GRK2水平升高与交感神经兴奋性增加及ACS严重程度分级有关。Objective To investigate the adjustment and value of lymphocyte G protein-coupled receptor kinase-2 （GRK2） protein levels in patients with acute coronary syndrome（ACS）. Methods Forty-two patients with stable angina pectoris （SAP）, 44 patients with unstable angina pectoris （UAP）, 43 patients with acute myocardial infarction （AMI）, and 46 patients with normal coronary angiography （NCA） in hospital were enrolled in this study. Lymphocyte GRK2 protein levels were analyzed by Western blot in 24 h after admitted to hospital. Heart rate variability （HRV） analysis was performed based on 24 h Holter electrocardiogram （ECG） monitoring. Cardiac functions were measured using ultrasonic cardiogram. The results were compared and the relationship between GRK2 protein levels and HRV, cardiac functions index was analyzed. Results The level of lymphocyte GRK2 in AMI group, UAP group, SAP group and NCA group was （209.8 ± 63.9）%, （165.6 ± 60.2）%, （131.7 ± 51.8）% and （125.3 ± 50.6）%. The levels of lymphocyte GRK2 in AMI group and UAP group was significantly higher than that in SAP group and NCA group .Moreover, the level of GRK2 was the highest in AMI group, and there were significant differences （P〈0.01）. The level of lymphocyte GRK2 had negative correlation with high frequency（HF）, low frequency（LF）, LF/HF, standard deviation NN interval （SDNN）, standard deviation of the average normal RR interval for 5-minute segments （SDNNI） and left ventricular ejection fraction （LVEF） （r =-0.52,-0.47,-0.53,-0.56,-0.49,-0.51, P 〈 0.01）. Conclusions The rise of lymphocyte GRK2 protein levels is significantly associated with increased sympathetic nerve excitabilityand deterioration of cardiac function.

关 键 词：急性冠状动脉综合征 G蛋白耦联受体激酶2 心率变异性 

分 类 号：R541.4[医药卫生—心血管疾病]