急性冠脉综合征患者替罗非班治疗后过氧化物酶体增生激活型受体γ与CD40/CD40L通路表达的变化  

The expression of peroxisome proliferator-activated receptor γ and CD40/CD40L pathway in acute coronary syndrome patients after treatment by tirofiban

作　　者：张利峰[1] 孙密欣 刘吉祥[1] 牛红梅[1] 谷世奎[1] 石俊岭[1] Zhang Lifeng;Sun Mixin;Liu Jixiang;Niu Hongmei;Gu Shikui;Shi Junling(Department of Cardiology,the First Hospital of Handan,Handan 056002,China)

机构地区：[1]邯郸市第一医院心血管内科,056002

出　　处：《中华诊断学电子杂志》2018年第1期53-56,共4页Chinese Journal of Diagnostics(Electronic Edition)

摘　　要：目的观察急性冠脉综合征(ACS)患者替罗非班治疗后过氧化物酶体增生激活型受体γ(PPARγ)与CD40/CD40L通路表达的变化。方法选取2016年12月至2017年7月邯郸市第一医院心内科ACS患者120例,随机数字表法分成4组,为常规治疗组和常规治疗+替罗非班12 h、24 h、36 h组,每组30人,进行随机对照研究。替罗非班组经皮冠状动脉介入治疗(PCI)术12 h后、24 h后、36 h后分别抽取患者血液,酶联免疫吸附法(ELISA)测定PPARγ与CD40、CD40L蛋白水平的表达,反转录-聚合酶链反应(RT-PCR)方法检测PPARγ与CD40、CD40L m RNA表达。结果与常规治疗组比较,替罗非班12 h、24 h、36 h组CD40与CD40L蛋白水平表达逐渐降低,CD40水平分别为(0.86±0.08)μg/L、(0.46±0.05)μg/L、(0.40±0.05)μg/L;CD40L水平分别为(0.92±0.04)μg/L、(0.54±0.04)μg/L和(0.40±0.05)μg/L,均差异有统计学意义(F=1 977.39,5 071.39;均P<0.01);PPARγ蛋白表达水平上升,分别为(0.94±0.04)μg/L、(1.40±0.01)μg/L和(1.48±0.01)μg/L,差异有统计学意义(F=4 719.81,P<0.01);替罗非班组CD40和CD40L m RNA表达逐渐降低,分别为0.98±0.07、0.50±0.02、0.41±0.01和1.02±0.06、0.50±0.02、0.40±0.01,均差异有统计学意义(F=5 781.52,5 935.29;均P<0.01);PPARγm RNA表达升高,分别为0.74±0.04、1.31±0.01和1.49±0.01,差异有统计学意义(F=4 683.59,P<0.01)。结论替罗非班能上调PPARγ表达,同时抑制CD40/CD40L通路的激活,具有抑制炎症、稳定粥样斑块作用。Objective To observe the expression of peroxisome proliferator-activated receptorγ(PPARγ)and CD40/CD40L pathway in patients with acute coronary syndrome(ACS)who were treated with tirofiban.Methods One hundred and twenty ACS patients in cardiology department of Handan No.1 hospital were selected from December 2016 to July 2017.All patients were randomly divided into control group and tirofiban groups according to random number table,blood samples of patients in tirofiban groups were collected 12 h,24 h and 36 h after percutaneous coronary intervention(PCI).The protein expression levels of CD40,CD40L and PPARγwere measured by enzyme-linked immunosorbent assay(ELISA).CD40,CD40L and PPARγmRNA levels were assayed by reverse transcription-polymerase chain reaction(RT-PCR).Results In tirofiban groups,CD40 and CD40L protein expression decreased,the levels of CD40 and CD40L were(0.86±0.08)μg/L,(0.46±0.05)μg/L,(0.40±0.05)μg/L and(0.92±0.04)μg/L,(0.54±0.04)μg/L,(0.40±0.05)μg/L,respectively.PPARγexpression increased,(0.94±0.04)μg/L,(1.40±0.01)μg/L and(1.48±0.01)μg/L,respectively.Compared with control group,the differences were statistically significant(F=1 977.39,5 071.39,4 719.81,all P<0.01).The expression of CD40(0.98±0.07,0.50±0.02,0.41±0.01)and CD40L(1.02±0.06,0.50±0.02,0.40±0.01)mRNA decreased,and PPARγincreased(0.74±0.04,1.31±0.01,1.49±0.01).The differences also had statistical significance(F=5 781.52,5 935.29,4 683.59,all P<0.01).Conclusion Tirofiban could up-regulate the expression of PPARγ,and inhibit the activation of CD40/CD40L signaling pathway so that it can suppress inflammation and stabilize atheromatous plaque.

关 键 词：替罗非班 过氧化物酶体增殖物激活受体 CD40/CD40L通路 急性冠状动脉综合征 

分 类 号：R541.4[医药卫生—心血管疾病]