人冠状动脉粥样硬化斑块内YKL-40、CXCL2、IFN-γ的表达及其与冠心病猝死的关系  

Expression of YKL-40,CXCL2 and IFN-γwithin human coronary atherosclerotic plaques and its association with sudden death in coronary heart disease

作　　者：乐翠云 万昌武 彭进 王杰 张桥军 苟吉 夏冰 LE Cuiyun;WAN Changwu;PENG Jin;WANG Jie;ZHANG Qiaojun;GOU Ji;XIA Bing(Department of Forensic Medicine/the Forensic Judicial Expertise Center,Guizhou Medical University,Guiyang 550004,China)

机构地区：[1]贵州医科大学法医学院/法医司法鉴定中心,贵阳550004

出　　处：《临床与实验病理学杂志》2023年第9期1055-1060,共6页Chinese Journal of Clinical and Experimental Pathology

基　　金：国家自然科学基金(82060340);贵州省科技计划项目[黔科合基础-ZK(2022)一般357]。

摘　　要：目的 探讨YKL-40及其下游炎症信号分子γ干扰素(interferon-γ, IFN-γ)、CXCL2在人冠状动脉粥样硬化斑块内的表达及其与冠状动脉粥样硬化斑块结构、冠状动脉粥样硬化性心脏病(coronary heart disease, CHD)引起猝死的关系。方法 筛选尸检案例库中心脏冠状动脉标本66例,分为3组:CHD组24例、CHD猝死组24例、对照组18例。测量冠状动脉内膜(含病灶)厚度、纤维帽厚度、坏死灶厚度及血管腔狭窄程度4个形态学指标综合评价血管结构;检测冠状动脉粥样硬化斑块内YKL-40及其下游信号分子CXCL2、IFN-γ的表达水平及分布特点;分析冠状动脉粥样硬化斑块内YKL-40表达与冠状动脉粥样硬化斑块结构指标间的相关性,探讨其与SCD的关系。结果 同对照组比较,CHD组和CHD猝死组冠状动脉粥样硬化病灶的内膜厚度和坏死核心增厚、纤维帽变薄、血管狭窄程度增高(P<0.01)。CHD组和CHD猝死组冠状动脉血管YKL-40、CXCL2及IFN-γ的蛋白表达量明显高于对照组,而CHD猝死组高于CHD组(P<0.01)。CHD组和CHD猝死组冠状动脉内膜病灶内YKL-40表达的平均光密度值与内膜厚度、坏死灶厚度及管腔狭窄程度呈正相关(r=0.969,P<0.001;r=0.780,P<0.001;r=0.833,P<0.001),而与纤维帽厚度呈负相关(r=-0.916,P<0.001)。CHD组和CHD猝死组冠状动脉内膜病灶内YKL-40蛋白表达平均光密度值与CXCL2蛋白表达平均光密度值呈正相关(r=0.983,P<0.001),与IFN-γ蛋白表达平均光密度值呈正相关(r=0.973,P<0.001)。结论 人冠状动脉粥样硬化斑块内YKL-40表达水平增加,其表达水平与冠状动脉粥样硬化不稳定性事件的发生有关,其机制可能是通过调节CXCL2和IFN-γ的表达来发挥作用。Purpose To investigate the expression of YKL-40 and its downstream signaling molecules IFN-γand chemokine CXCL2 within human coronary atheromatous plaques and their relationship with coronary atheromatous plaque structure and sudden death in coronary heart disease(CHD).Methods Sixty-six eligible cardiac coronary artery specimens were selected and divided into three groups:CHD group(24 cases),sudden death in CHD group(24 cases),and simultaneous autopsy coronary artery cases were used as the control group(18 cases).Four morphological indexes including coronary intima(lesion containing)thickness,the thickness of fibrous cap,thickness of necrosis core and degree of lumen stenosis were measured to comprehensively evaluate the vascular structure.The expression levels and distribution characteristics of YKL-40,CXCL2 and IFN-γin coronary atheromatous plaques were detected.The correlation between the expression of YKL-40 in atherosclerotic plaques and the structural indicators of coronary atherosclerotic plaques was analyzed to explore its relationship with sudden coronary death.Results Compared with the control group,the CHD group and sudden death in CHD group had thickened intima and necrotic core,thinner fibrous cap,and higher degree of stenosis in atherosclerotic lesions(P<0.01).The protein expression of YKL-40 and CXCL2 and IFN-γin coronary vessels was significantly higher in the CHD group and the sudden death in CHD group than that in the control group,whereas it was higher in the sudden death in CHD group than that in the CHD group(P<0.01).The mean optical density values of YKL-40 expression within coronary endothelial lesions in the CHD and sudden death in CHD groups were positively correlated with endothelial thickness,thickness of necrotic foci,and luminal stenosis course(r=0.969,P<0.001,r=0.780,P<0.001,r=0.833,P<0.001)and negatively correlated with fibrous cap thickness(r=-0.916,P<0.001).YKL-40 protein expression optical density values within coronary endothelial lesions in the CHD and sudden death in CHD gr

关 键 词：冠心病 动脉粥样硬化 YKL-40 炎症反应 猝死 

分 类 号：R543.3[医药卫生—心血管疾病]