ST段抬高型心肌梗死患者LOX-1、CX3CR-1与罪犯斑块类型及斑块负荷程度的关系  

Correlation between LOX-1,CX3CR-1 in monocytes and culprit lesion morphology,coronary atherosclerotic burden in ST-segment elevated myocardial infarction patients

作　　者：徐峰 吴宗贵 李永光[2] Xu Feng;Wu Zonggui;Li Yongguang(Department of Cardiology,Shanghai Long March Hospital(Second Affiliated Hospital of Naval Military Medical University),Shanghai 200003,China;Department of Cardiology,Shanghai Sixth People's Hospital,Shanghai 200233,China)

机构地区：[1]上海长征医院(海军军医大学第二附属医院)心内科,200003 [2]上海市第六人民医院心内科,200233

出　　处：《中国心血管杂志》2021年第2期131-136,共6页Chinese Journal of Cardiovascular Medicine

摘　　要：目的探讨ST段抬高型心肌梗死(STEMI)患者单核细胞凝集素样氧化型低密度脂蛋白受体1(LOX-1)、趋化因子fractalkine特异性受体1(CX3CR-1)与罪犯斑块类型及斑块负荷程度的相关性。方法收集2019年1~10月在上海长征医院确诊的STEMI患者100例,根据光学相干断层成像(OCT)图像分析,分为斑块破裂组(61例)和斑块侵蚀组(39例),并纳入健康志愿者作为对照组(50例)。检测单核细胞LOX-1、CX3CR-1表达量。对STEMI患者进行OCT检查和冠状动脉造影,判断罪犯斑块类型,计算Gensini评分和SYNTAXⅡ评分,应用logistic回归分析STEMI患者单核细胞LOX-1、CX3CR-1表达量与斑块破裂的相关性。结果3组的年龄、男性比例、体质指数、吸烟史、饮酒史比例等均无统计学差异(均为P>0.05)。经流式细胞术检测,斑块破裂组STEMI患者单核细胞LOX-1、CR3CR-1表达量显著高于对照组和斑块侵蚀组(均为P<0.05);对照组和斑块侵蚀组单核细胞LOX-1、CR3CR-1表达量相似(均为P>0.05)。经单因素和多因素logistic回归分析,单核细胞LOX-1(OR=4.18,95%CI:2.51~6.95)和CX3CR-1(OR=1.91,95%CI:1.02~4.57)仍是斑块破裂的独立影响因素(均为P<0.05)。且随着罪犯斑块负荷增加,LOX-1、CX3CR-1表达量也逐渐升高(均为P<0.05)。根据SYNTAXⅡ评分系统分组,高危者单核细胞LOX-1、CX3CR-1表达量均高于低危者(均为P<0.05)。结论斑块破裂患者单核细胞LOX-1、CX3CR-1表达量高于斑块侵蚀患者,且与罪犯斑块负荷程度正相关。Objective To investigate the correlation between monocyte lectin-like oxidized low-denisty lipoprotein receptor-1(LOX-1),receptor for the CX3C chemokine fractalkine(CX3CR-1)in monocytes and culprit lesion morphology,coronary atherosclerotic burden in patients with ST-segment elevated myocardial infarction(STEMI).Methods A total of 100 STEMI patients diagnosed in Shanghai Changzheng Hospital from January 2019 to October 2019 were collected.According to Optical Coherence tomography(OCT)analysis,100 STEMI patients were divided into plaque rupture group(61 cases)and plaque erosion group(39 cases),and included healthy volunteers as the control group(50 cases).The expression of LOX-1 and CX3CR-1 in monocytes was detected.OCT and coronary angiography were performed in STEMI patients to determine the type of culprit plaque.Gensini score and syntaxⅡscore were calculated.The correlation between the expression of LOX-1 and CX3CR-1 in monocytes and plaque rupture was analyzed by logistic regression.Results There was no significant difference in age,male ratio,body mass index,smoking history and drinking history among the three groups(all P>0.05).The expression levels of LOX-1 and CX3CR in monocytes of STEMI patients in plaque rupture group were significantly higher than those in control group and plaque erosion group(P<0.05),but there were no significant differences in monocyte LOX-1 and CX3C-R expressions between the control group and the plaque erosion group(P>0.05).Univariate and multivariate logistic regression analysis showed that the expression of LOX-1(OR=4.18,95%CI:2.51-6.95)and CX3CR-1(OR=1.91,95%CI:1.02-4.57)were still independent influencing factors of plaque rupture(P<0.05).With the increase of culprit plaque load,the expression of LOX-1 and CX3CR-1 in monocytes of STEMI patients increased gradually(P<0.05).According to the syntaxⅡscoring system,the expression of LOX-1 and CX3CR-1 in monocytes of high-risk group was higher than that of low-risk group(P<0.05).Conclusions The expression levels of LOX-1 and CX3C

关 键 词：急性心肌梗死 凝集素样氧化型低密度脂蛋白受体1 趋化因子fractalkine特异性受体1 罪犯斑块 斑块负荷 

分 类 号：R54[医药卫生—心血管疾病]