自噬相关基因在冠状动脉支架内再狭窄患者中的水平变化及临床意义  

Change of autophagy-related genes and its clinical significance in instent restenosis patients after coronary stent implantation

作　　者：魏天龙 李德才 李双菲 杨玲梅 Wei Tianlong;Li Decai;Li Shuangfei;Yang Lingmei(Department of Cardiology,Mianyang 404 Hospital,Mianyang 621000,Sichuan Province,China)

机构地区：[1]四川绵阳四○四医院心血管内科,621000

出　　处：《中华老年心脑血管病杂志》2021年第10期1046-1049,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：四川省卫生和计划生育委员会科研课题(17PJ019)。

摘　　要：目的研究自噬相关基因在冠状动脉支架内再狭窄(ISR)患者中的变化及临床意义。方法选取我院心血管内科成功接受冠状动脉药物洗脱支架置入术并行冠状动脉造影复查的患者256例,分为ISR组64例和非ISR组192例,ELISA法测外周血白细胞介素17(IL-17)、TNF-α和氧化应激指标谷胱甘肽(GSH)、丙二醛水平,实时荧光定量PCR测Beclin-1、微管相关蛋白轻链3(LC3)ⅡmRNA水平。结果ISR组冠状动脉病变≥2支、置入支架≥2枚比例、外周血IL-17、TNF-α及丙二醛水平明显高于非ISR组,Beclin-1、LC3-ⅡmRNA及GSH水平明显低于非ISR组(P<0.05,P<0.01)。冠状动脉病变≥2支、置入支架≥2枚、Beclin-1和LC3-ⅡmRNA水平降低是ISR形成的独立危险因素(P<0.05,P<0.01)。ISR患者Beclin-1和LC3-ⅡmRNA水平分别与外周血IL-17、TNF-α及丙二醛水平呈显著负相关,与GSH水平呈显著正相关(P<0.05,P<0.01)。Beclin-1和LC3-ⅡmRNA预测ISR的AUC分别为0.831(95%CI:0.762~0.900)和0.803(95%CI:0.708~0.898)。结论ISR的发生与机体细胞自噬的降低密切相关,其可作为ISR发生的独立危险因素,对评估ISR的发生具有一定临床价值。Objective To study the change of autophagy-related genes and its clinical significance in instent restenosis patients after coronary stent implantation.Methods Two hundred and fifty-six patients who underwent successful drug-eluting stent implantation and coronary angiography in our hospital were divided into instent restenosis group(n=64)and instent restenosis-free group(n=192).The serum levels of IL-17 and TNF-α,Beclin-1,LC3-ⅡmRNA,GSH and malondialdehyde were measured.Results The incidence of coronary artery lesions≥2 and the serum levels of IL-17,TNF-α,malondialdehyde were significantly higher,the number of implanted stents(≥2)was significantly greater while the serum levels of Beclin-1 and LC3-ⅡmRNA and GSH were significantly lower in instent restenosis group than in instent restenosis-free group(P<0.05,P<0.01).The coronary artery lesions≥2,coronary stents≥2 and low serum levels of Beclin-1 and LC3-ⅡmRNA were independent risk factors for instent restenosis formation(P<0.05,P<0.01).The serum levels of Beclin-1 and LC3-ⅡmRNA were negatively related with those of IL-17,TNF-α,malondialdehyde and positively related with those of GSH in instent restenosis patients(P<0.05,P<0.01).The AUC of Beclin-1 and LC3-ⅡmRNA for predicting instent restenosis was 0.831(95%CI:0.762-0.900)and 0.803(95%CI:0.708-0.898)respectively.Conclusion Instent restenosis is closely related with the reduced autophagy which is an independent risk factor for instent restenosis and has a certain clinical value for assessing instent restenosis.

关 键 词：自噬 冠状动脉再狭窄 药物洗脱支架 冠状血管造影术 

分 类 号：R541.4[医药卫生—心血管疾病]