急性冠状动脉综合征患者外周血树突状细胞来源Exosomes表型与冠状动脉病变严重程度的相关性分析  

Correlation between peripheral blood dendritic cells-derived exosomes and severity of coronary artery lesions among patients with acute coronary syndrome

作　　者：楚扬[1] 王丽岩[1] 牛文豪[1] 伍锋[1] 梁鑫[1] 贺治青[1] 丁茹[1] 梁春[1] 

机构地区：[1]中国人民解放军第二军医大学附属长征医院心血管内科,上海200003

出　　处：《疑难病杂志》2017年第6期550-553,557,共5页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的分析急性冠状动脉综合征患者外周血树突状细胞来源Exosomes表型与冠状动脉病变严重程度的相关性。方法选择2015年9月—2016年5月在第二军医大学附属长征医院心内科初次行冠状动脉造影(CAG)检查的患者122例作为研究对象,根据病史及检查结果分为对照组(NC组)34例,稳定性心绞痛组(SA组)30例,急性冠状动脉综合征组(ACS组)58例,收集患者一般情况、危险因素(吸烟史、高血压病史及糖尿病病史等情况),分析总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)等指标,术中留取外周静脉全血,使用抽提试剂盒提取Exosomes,经流式细胞仪检测其表面抗原CD11c表达水平,根据冠状动脉造影检查结果计算Gensini积分,评价冠状动脉病变严重程度,比较不同组之间Exosomes表型CD11c水平的差异并与Gensini评分进行相关性分析。结果 ACS组CK、CK-MB、Gensini评分、外周血CD11c表达水平均显著高于UA组和NC组(F=3.671、4.263、2.971、3.162,P<0.05)。外周血CD11c水平与Gensini积分CK、CK-MB呈正相关性(r=0.844、0.513、0.571,P<0.05或P<0.01)。Logistic回归分析结果表明,CD11c为Gensini积分的独立危险因素(OR=2.221,P=0.000)。结论外周血树突状细胞来源Exosomes(即CD11c阳性表型)水平与急性冠状动脉综合征患者冠状动脉病变严重程度密切相关,提示树突状细胞来源的Exosomes可能参与了动脉粥样硬化病变的发展。Objective To investigate the correlation between peripheral blood dendritic cells-derived exosomes and severity of coronary artery lesions among patients with acute coronary syndrome （ACS）.Methods From September 2015 to May 2016, patients who received coronary angiography in Department of Cardiology, Shanghai Changzheng Hospital were enrolled （n=122）.Based on disease history and examination results, such patients were divided into the following three groups, including control group （NC,n=34）, patients with stable angina pectoris （SA,n=30）, patients with acute coronary syndrome （ACS,n=58）.Age, sex, the cholesterol （TC）, triglyceride （TG）, low density lipoprotein cholesterol （LDL-C）, high density lipoprotein cholesterol （HDL-C）, CK, CK-MB and other indicators were collected, history of smoking, history of hypertension and diabetes, peripheral blood samples were recorded, take exosomes extraction kit to extract exosomes, and the detection of its surface antigen CD11c expression by flow cytometry.According to coronary angiography （CAG） imaging, Gensini integral calculation were performed, evaluated the severity of coronary artery disease, than the difference of CD11c expression between different groups and the correlation with Gensini score were analyzed.Results Compared with the UA group, ACS group＇s expression levels showed significant differences in the scores of Gensini（F=3.671,4.263,2.971,3.162,P〈0.05）,CD11c in peripheral blood was positively correlated with Gensini score,CK,CK-MB（r=0.844,0.513,0.571,P〈0.05,P〈0.01）;further regression analysis showed that the level of CD11c in peripheral blood of ACS group increased, and positively correlated with the increased Gensini score（OR=2.221,P=0.000）.Conclusion Peripheral blood exosomes phenotype and expression of CD11c gene in acute coronary syndrome with the severity of coronary artery disease is closely related to the development of these results, which suggest that dendritic cell derived exosomes may be invo

关 键 词：急性冠状动脉综合征 树突状细胞 EXOSOMES 冠状动脉造影 GENSINI评分 

分 类 号：R541.4[医药卫生—心血管疾病]