蛋白激酶C活性与糖尿病足截肢患者胫前动脉钙化积分的相关性  

Correlation between protein kinase C activity and anterior tibial artery calcification score in patients with diabetic foot amputation

作　　者：李丽华[1] 叶斐[2] 付先利[1] 吴建农[1] 严金川[2] 邵晨[2] 王中群[2] LI Li-Hua YE Fei FU Xian-Li WU Jian-Nong YAN Jin-Chuan SHAO Chen WANG Zhong-Qun(Department of Pathology Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu 212001, China)

机构地区：[1]江苏大学附属医院病理科,江苏省镇江市212001 [2]江苏大学附属医院心内科,江苏省镇江市212001

出　　处：《中国动脉硬化杂志》2017年第4期373-377,共5页Chinese Journal of Arteriosclerosis

基　　金：国家自然科学基金项目(81370408;81370409);江苏省自然科学基金项目(BK20131246);江苏省卫生厅项目(Q201308);镇江市社会发展项目(SH2015038;SH2015023;SHW2015001);卫生部核医学重点实验室;江苏省分子核医学重点实验室开放课题(KF201504);江苏大学临床专项项目(JDLCZX001)

摘　　要：目的探讨蛋白激酶C(PKC)活性与糖尿病足截肢患者胫前动脉钙化之间的相关性。方法选取2012年10月至2016年1月在江苏大学附属医院骨科行糖尿病足大截肢住院治疗的患者共60例,根据CT对胫前动脉钙化程度的检测将患者分为轻度钙化组(n=20)、中度钙化组(n=20)及重度钙化组(n=20)。通过患者临床基线资料的采集以及胫前动脉组织连续石蜡切片Von Kossa染色观察钙化演进,通过PepTag~Assay法检测组织细胞膜PKC活性,通过Western blot检测对PKCα亚型进行半定量分析。结果糖尿病足截肢患者胫前动脉Von Kossa染色与相应的动脉CT扫描结果一致:胫前动脉斑块内的钙盐沉积呈点灶状分布,而且随着胫前动脉内斑块的不断扩大乃至管腔闭塞,钙颗粒的密度也有不同程度的增加,但始终呈点灶状分布的微钙化。定量检测及Pearson相关性分析显示PKC活性与糖尿病足胫前动脉钙化积分正相关(r=0.931,P<0.001),进一步分析显示可能是PKCα亚型发挥了促进钙化演进的作用。结论 PKCα亚型的活化可能与糖尿病动脉斑块内钙化的演进存在正相关,其水平可能对针对性干预血管钙化有着一定的价值。Aim To observe the relationship between protein kinase C （PKC） activity and anterior tibial artery calcification score in patients with diabetic foot. Methods 60 diabetic patients hospitalized for above-knee amputation in the Department of Orthopedics, Mfiliated Hospital of Jiangsu University were recruited from October 2012 to January 2016. The patients were categorized based on the severity of anterior tibial artery calcification, which was assessed by computed tomography （CT）, into mild calcification group （0〈calcification score〈 100, n= 20）, moderate stenosis group （ 100 ≤ calcification score〈200, n=20） and severe calcification group （calcification score≥200, n=20）. Baseline clinical data regarding sex, age, duration of diabetes mellitus, hypertension status, fasting plasma glucose （ FPG）, glycated hemoglobin （HbAlc）, and lipid profile were collected before the amputation. Von kossa staining, PepTag Assay and Western blot were then performed. Results Similarly with Von Kossa staining, CT scan results showed that calcium deposition in anterior tibial artery plaques of diabetic patients hospitalized for above-knee amputation were enlarged and calcium particles density in moderate and severe groups were stronger than that in mild group. The calcification in all calcification groups were showed as spotty calcification. PepTag Assay, Western blot and Pearson correlation showed that anterior tibial artery calcification score in diabetic patients hospitalized for above-knee amputation was positively associated with PKC activity （r= 0.931, P〈0.001）. Further analysis indicated that alpha subtypes of PKC maybe played an important role to promote the evolution of calcification. Conclusion The activation of PKC subtypes may be related with the evolution of calcification in atherosclerotie plaques, so as to further target the mechanism of vascular calcification.

关 键 词：糖尿病足 动脉粥样硬化 血管钙化 蛋白激酶C 

分 类 号：R329-33[医药卫生—人体解剖和组织胚胎学]