程序性细胞死亡因子4与急性ST段抬高型心肌梗死患者冠状动脉病变程度的关系  

Relationship between programmed cell death 4 and severity of coronary artery disease in patients with acute ST segment elevation myocardial infarction

作　　者：肖开永 肖莲 何忠伟 王建平[1] Xiao Kaiyong;Xiao Lian;He Zhongwei;Wang Jianping(Department of Cardiology,Central Hospital of Guangyuan City,Guangyuan 628000,China)

机构地区：[1]四川省广元市中心医院心脏血管内科,628000

出　　处：《心脑血管病防治》2021年第6期548-551,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：目的探讨外周血程序性细胞死亡因子4(PDCD4)在急性ST段抬高型心肌梗死(STEMI)患者中表达及其与冠状动脉病变严重程度及预后的关系。方法回顾性分析2017年1月至2019年12月广元市中心医院收治的110例STEMI患者为观察组,其中轻度病变22例,中度病变51例,重度病变37例,另外选取同期行冠状动脉造影检查且未见血管异常或狭窄的健康体检者72例为对照组。采用Gensini评分对冠状动脉造影结果进行评估;采用荧光实时定量聚合酶链反应(qRT-PCR)检测CD4^(+)T细胞中PDCD4 mRNA表达水平;随访6个月,观察主要不良心血管事件(MACE)发生率,并采用Logistic回归模型分析影响STEMI患者发生MACE的危险因素。结果与对照组相比,观察组CD4^(+)T细胞中PDCD4 mRNA水平较高(t=19.427,P <0.05);轻度病变组、中度病变组、重度病变组CD4^(+)T细胞中PDCD4 mRNA水平依次升高(F=26.240,P <0.05);本组STEMI患者中MACE事件发生率为24.55%(27/110)。有MACE事件患者PDCD4 mRNA、Gensini评分明显高于无MACE事件患者(t=5.966、21.651,P <0.05)。Spearman结果显示,观察组CD4^(+)T细胞中PDCD4 mRNA表达水平与Gensini评分呈正相关(r=0.600,P <0.05);PDCD4 mRNA、Gensini评分是影响STEMI患者发生MACE的危险因素[OR(95%CI)=1.768(1.183~2.642)、2.642(1.425~4.899),P <0.01]。结论 STEMI患者CD4^(+)T细胞中PDCD4 mRNA表达水平较高,且与冠状动脉病变严重程度呈正相关,是STEMI患者发生MACE的危险因素,PDCD4可作为预测和评估STEMI患者病变程度及预后的指标。Objective To investigate relationship between the expression of programmed cell death factor 4(PDCD4) and severity of coronary artery lesions and prognosisin in patients with acute ST segment elevation myocardial infarction(STEMI). Methods 110 patients with STEMI admitted to Guangyuan Central Hospital from January 2017 to December 2019 were retrospectively analyzed as the observation group, including 22 cases of mild lesions, 51 cases of moderate lesions, 37 cases of severe lesions. 72 people who underwent coronary angiography at the same time without vascular abnormalities or stenosis were selected as the control group. Gensini score was used to evaluate the results of coronary angiography;the expression of PDCD4 mRNA in CD4^(+)T cells was detected by real time quantitative polymerase chain reaction(qRT-PCR);the incidence of major adverse cardiovascular events(MACE)was observed after 6 months of follow-up. Logistic regression model was used to analyze the risk factors influencing the occurrence of MACE in STEMI patients. Results Compared with the control group,the level of PDCD4 mRNA in CD4^(+)T cells in the observation group was higher(t=19.427, P < 0.05);the level of PDCD4 mRNA in CD4^(+)T cells of the mild lesion group, moderate lesion group and severe lesion group increased successively(F=26.240, P < 0.05). The incidence of MACE was 24.55%(27/110).PDCD4 mRNA and Gensini score in patients with MACE were significantly higher than those in patients without MACE(t=5.966,21.651;P < 0.05). Spearman results showed that the expression of PDCD4 m RNA in CD4^(+)T cells was positively correlated with Gensini score(r=0.600, P < 0.05);PDCD4 m RNA and Gensini score were the risk factors of MACE in STEMI patients [OR(95%CI)=1.768(1.183-2.642), 2.642(1.425-4.899);P < 0.01]. Conclusion The expression of PDCD4 m RNA in CD4^(+)T cells of STEMI patients increases, and is positively correlated with the severity of coronary artery lesions, served as is a risk factor for MACE in STEMI patients. PDCD4 can be used as an index to pre

关 键 词：ST段抬高型心肌梗死 程序性细胞死亡因子4 CD4 T细胞 

分 类 号：R542.22[医药卫生—心血管疾病]