Angptl4在下肢动脉硬化闭塞症患者中的表达及临床意义  

Expression and clinical significance of Angptl4 in patients with lower extremity arteriosclerosis obliterans

作　　者：孙勇[1] 聂中林[1] 宋涛[1] 王孝高[1] 徐超[1] 余朝文 Sun Yong(Vascular surgery department,the first affiliated hospital of Bengbu,Medical College,Bengbu,Anhui,233004,China)

机构地区：[1]蚌埠医学院第一附属医院血管外科,安徽蚌埠233004 [2]不详

出　　处：《齐齐哈尔医学院学报》2021年第16期1381-1386,共6页Journal of Qiqihar Medical University

基　　金：蚌埠医学院自然科学重点项目(BYKY2019110ZD)。

摘　　要：目的探究类血管生成素样蛋白4(Angptl4)在下肢动脉硬化闭塞症(ASO)患者中的表达和临床意义。方法选择2019年5月—2020年1月于本院确诊并行手术治疗的ASO患者90例作为研究对象,设为ASO组,根据Rutherford分级标准确定1级20例、2级17例、3级20例、4级18例、5级15例,同时随机选择同时期内于本院检查的健康志愿30名作为健康组。获取ASO组术前、术后及健康组患者基线资料、实验室指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)、超敏C反应蛋白(hs-CRP)、空腹血糖(FPG)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、Angptl4水平及术后Rutherford评分,探究Angptl4水平与脂质代谢水平、ASO发生发展及预后的相关性;在细胞水平用氧化型低密度脂蛋白(ox-LDL)构建内皮细胞损伤模型,同时转染Angptl4干扰和过表达载体上调或抑制其表达,探究Angptl4对内皮细胞保护作用及相关炎性因子[TNF-α、IL-1、hs-CRP、一氧化氮(NO)、内皮素-1(ET-1)、血管紧张素Ⅱ(AngⅡ)]的表达调控。结果ASO组Angptl4、HDL-C低于健康组而TNF-α、hs-CRP、LDL-C高于健康组(P<0.05);血清Angptl4水平与HDL-C呈正相关(P<0.05),与TNF-α、hs-CRP、LDL-C呈负相关(P<0.05),与ASO严重程度呈负相关(P<0.05),与预后进展呈正相关(P<0.05)。体外实验结果显示:ox-LDL刺激和Angptl4转染后Angptl4表达增高;Angptl4转染后可削弱内皮损伤细胞的增殖抑制作用、炎性细胞浸润情况,可降低TNF-α、IL-1、hs-CRP、ET-1、AngⅡ而提高NO水平。结论Angptl4可能通过促进脂质代谢、保护内皮细胞损伤抑制ASO发生发展,并抑制PTA术后RS形成。Objective To investigate the expression and clinical significance of Angiopoietin-like protein(Angptl4)in patients with lower extremity arteriosclerosis obliterans(ASO).Methods 90 patients with ASO those confirmedand underwent surgery in our hospital from May 2019 to January 2020 were selected as study subjects,and they were classified according to Rutherford grading criteria,including 20 cases of grade 1,17 cases of grade 2,20 cases of grade 3,18 cases of grade 4,and 15 cases of grade 5.Meanwhile,30 healthy volunteers who were examined in our hospital during the same period were randomly selected.Baseline data,laboratory indicators[tumor necrosis factor-α(TNF-α),interleukin-1(IL-1),high sensitivity C-reactive protein(hs-CRP),fasting plasmaglucose(FPG),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)],Angptl4 level and postoperative Rutherford score were obtained.The correlation between Angptl4 level and lipid metabolism leveland the development and prognosis of ASO was analyzed.Oxidized low-density lipoprotein(ox-LDL)was used to construct endothelial cell injurymodel,and was transfected with Angptl4 interference and over-expression vectors to up-regulate or inhibit its expression.Protective effect of Angptl4 on endothelial cells and the regulation of the related inflammatory factors[TNF-α,IL-1,hs-CRP,nitric oxide(NO),endothelin-1(ET-1),angiotensinⅡ(AngⅡ)]were also analyzed.Results Angptl4 and HDL-C in the ASO group were lower than those in the healthy group,while TNF-α,hs-CRP,and LDL-C were higher in the healthy group(P<0.05).Serum Angptl4 level was positively correlated with HDL-C(P<0.05),negatively correlated with TNF-α,hs-CRP,and LDL-C(P<0.05)and negatively correlated with the severity of ASO(P<0.05),and was positively correlated with the prognosis(P<0.05).The results of in vitro experiments showed that ox-LDL stimulation and Angptl4 transfection increased the expression of Angptl4;Angptl4 transfection could weakenthe proliferation inhibitory ef

关 键 词：类血管生成素样蛋白4 下肢动脉硬化闭塞症 表达 临床意义 

分 类 号：R543.5[医药卫生—心血管疾病]