冠心病患者外周血ATG-5、ATG-7水平与冠状动脉病变程度、心率变异性及斑块易损性的关系  

THE RELATIONSHIP BETWEEN ATG-5 AND ATG-7 LEVELS IN PERIPHERAL BLOOD AND THE DEGREE OF CORONARY ARTERY DISEASE,HEART RATE VARIABILITY,AND PLAQUE VULNERABILITY IN PATIENTS WITH CORONARY ARTERY DISEASE

作　　者：李巍 李彦明[2] LI Wei;LI Yanming(Department of Cardiology, Huaihe Hospital, Henan University, Kaifeng 475000, China)

机构地区：[1]河南大学淮河医院心内科,河南开封4750001 [2]河南大学淮河医院心电图科,河南开封4750001

出　　处：《精准医学杂志》2020年第6期533-536,539,共5页Journal of Precision Medicine

基　　金：2018年度河南省医学科技攻关计划项目(2018-020376)。

摘　　要：目的探讨冠心病患者外周血血清和单个核细胞中自噬相关基因5(ATG-5)和ATG-7蛋白的表达与冠状动脉病变严重程度、心率变异性(HRV)、斑块易损性的关系。方法选择2018年1月-2019年6月因不明原因胸痛在我院就诊的受试者248例,根据冠状动脉造影(CAG)结果,其中200例确诊为冠心病,包括125例稳定型心绞痛(SAP)患者和75例急性冠状动脉综合征(ACS)患者;其余48例CAG和心功能检查正常者作为对照组。采用ELISA法检测受检者血清中ATG-5和ATG-7水平,24 h动态心电图检查冠心病患者HRV指标。收集冠心病患者外周血单个核细胞,采用Western blot法检测ATG-5、ATG-7蛋白的表达。结果与对照组相比,冠心病组患者血清中ATG-5和ATG-7水平明显升高(Z=17.154、25.845,P<0.05)。冠心病组患者血清中ATG-5和ATG-7水平与全部R-R间期的标准差、正常相邻每5min R-R间期均数标准差、正常相邻间期差值>50 ms的心搏数占总心搏数的百分比呈负相关(r=-0.489^-0.172,P<0.05)。ACS组患者血清中ATG-5和ATG-7水平明显高于SAP组(Z=11.089、33.127,P<0.05);但是单个核细胞中ATG-5和ATG-7水平却明显低于SAP组(t=10.598、15.351,P<0.05)。结论冠心病患者血清中ATG-5和ATG-7水平与冠状动脉病变程度和HRV有一定关联;而单个核细胞中ATG-5、ATG-7蛋白表达降低可能是ACS患者斑块稳定性下降的重要机制。Objective\To investigate the relationship between the protein expression of autophagy-related gene 5(ATG-5)and autophagy-related gene 7(ATG-7)in peripheral blood serum and mononuclear cells and the severity of coronary artery di-sease(CAD),heart rate variability(HRV),and plaque vulnerability in patients with CAD.\Methods\A total of 248 subjects who attended our hospital due to unexplained chest pain from January 2018 to June 2019 were enrolled in this study.According to the results of coronary angiography(CAG),200 subjects were diagnosed with CAD,including 125 cases of stable angina pectoris(SAP)and 75 cases of acute coronary syndrome(ACS);the rest(48 subjects)who showed normal results of CAG and cardiac function examination were selected as control group.Enzyme-linked immunosorbent assay was used to measure the levels of ATG-5 and ATG-7 in the sera of patients.The 24 h ambulatory electrocardiography was used to monitor the indices of HRV.Peripheral blood mononuclear cells were collected from patients with CAD,and Western blot was used to measure the expression of ATG-5 and ATG-7 proteins.\Results\Compared with the control group,the CAD patients had significantly higher levels of ATG-5 and ATG-7(Z=17.154,25.845,P<0.05).In addition,serum ATG-5 and ATG-7 levels in CAD patients were negatively correlated with the values of standard deviation of all normal RR intervals,standard deviation of the 5-min average NN intervals,and percen-tage of successive normal sinus RR intervals>50 ms(r=-0.489--0.172,P<0.05).ACS patients had significantly higher ATG-5 and ATG-7 levels in serum than SAP patients(Z=11.089,33.127,P<0.05),but had significantly lower ATG-5 and ATG-7 le-vels in mononuclear cells(t=10.598,15.351,P<0.05).\Conclusion\For patients with CAD,the serum levels of ATG-5 and ATG-7 are correlated with the degree or severity of CAD and HRV.For patients with ACS,the reduced protein expression of ATG-5 and ATG-7 in mononuclear cells may be an important mechanism of plaque vulnerability.

关 键 词：冠心病 自噬相关蛋白质5 自噬相关蛋白质7 冠状动脉狭窄 斑块 动脉粥样硬化 心率 血清 单个核细胞 

分 类 号：R541.4[医药卫生—心血管疾病]