血脂水平与载脂蛋白E和SLCO1B1基因多态性与晚期支架内再狭窄的相关性研究  

Relationships between lipid profiles,polymorphisms of ApoE and SLCO1B1 and late in-stent restenosis

作　　者：陈强 侯春霞 杨菲菲 张春红 熊敏俊 刘璐琳 马永江 张丽伟 CHEN Qiang;HOU Chun-xia;YANG Fei-fei;ZHANG Chun-hong;XIONG Min-jun;LIU Lu-lin;MA Yong-jiang;ZHANG Li-wei(Department of Cardiology,The Sixth Medical Center of Chinese PLA General Hospital,Beijing 100037,China)

机构地区：[1]中国人民解放军总医院第六医学中心心血管病学部,北京市100037

出　　处：《中国心血管病研究》2022年第1期8-13,共6页Chinese Journal of Cardiovascular Research

基　　金：北京市自然科学基金项目(7202198)。

摘　　要：目的对比分析晚期支架内再狭窄(in-stent restenosis,ISR)与无ISR患者的临床特点、血脂水平、载脂蛋白E(apolipoprotein E,ApoE)以及SLCO1B1基因的多态性,探讨影响晚期ISR的临床危险因素。方法入选2018年1月至2020年12月我院行冠状动脉造影证实晚期ISR的患者共61例,另外入选行冠状动脉造影证实无晚期ISR的患者共119例为对照组。比较两组的临床特点、血脂水平以及ApoE以及SLCO1B1基因的多态性。所有患者根据低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)水平分为<1.4 mmol/L组,1.4~1.8 mmol/L组以及>1.8 mmol/L组,=比较不同组别晚期ISR的发生率。结果晚期ISR组与无ISR组患者ApoE、SLCO1B1基因型以及等位基因的频率并无统计学差异(P>0.05),将不同基因型和等位基因频率分别进行组内两两对比,结果也无统计学差异(P>0.05)。两组患者总胆固醇(total cholesterol,TC)、LDL-C、载脂蛋白B(apolipoprotein B,ApoB)、ApoB/ApoA比值以及非高密度脂蛋白胆固醇(non-high-density lipoprotein cholesterol,n-HDL-C)水平均有统计学差异,晚期ISR组上述指标均比对照组偏高(P<0.05)。3.<1.4 mmol/L组的ISR发生率为17.9%,1.4~1.8 mmol/L组的ISR发生率为31.3%,>1.8 mmol/L组的ISR发生率为39.4%。不同LDL-C水平的组间总体ISR发生率并无统计学差异(P>0.05)。进一步行组间两两对比,小于<1.4 mmol/L组的ISR发生率为与>1.8 mmol/L组的ISR发生率有差异(P<0.05)。结论冠状动脉支架术后的患者,其ApoE或SLCO1B1的基因多态性与晚期ISR的发生率无明确关系。晚期ISR患者血脂水平较无ISR患者升高明显,将LDL-C降至1.4mmol/L以下可能有助于减少晚期ISR的发生。Objective To study the characteristics of clinical presentations,lipid profiles,polymorphisms of ApoE and SLCO1 B1 in the patients with and without late in-stent restenosis(ISR).Method 61 patients with angiographically confirmed late ISR and 119 patients without angiographically late ISR were selected for the study.Basic clinical features,lipid profiles and polymorphisms of ApoE and SLCO1 B1 were measured and compared between the two groups.All patients were then divided into three groups according to the levels of lowdensity lipoprotein cholesterol(LDL-C),and the rates of ISR in different group were compared.Results There were no significant differences of polymorphisms and allele frequencies of ApoE and SLCO1 B1 between different groups(P>0.05).The lipid profiles of total cholesterol(TC),LDL-C,apolipoprotein B(ApoB),ratios of ApoB/ApoA and non-high-density lipoprotein cholesterol(n-HDL-C) in late ISR group were significantly higher than in control group(P<0.05).There was no significant difference of total late ISR rate between the three groups according to the LDL-C levels;but in LDL-C<1.4 mmol/L group the ISR rate(17.9%) was significantly lower than in >1.8 mmol/L group(39.4%).(P<0.05).Conclusions There were no relationships between polymorphisms of Apo E and SLCO1 B1 and late ISR.The lipid profiles of late ISR group were significantly higher;reducing the LDL-C level to less than 1.4 mmol/l might help decreasing the ISR rate.

关 键 词：支架 冠状动脉再狭窄 血脂障碍 多态现象 遗传学 

分 类 号：R541.4[医药卫生—心血管疾病]