PM_(2.5)诱导血管内皮细胞凋亡在老年冠心病中的作用机制  

Mechanism of PM_(2.5)induced apoptosis of vascular endothelial cells in elderly patients with coronary heart disease

作　　者：张康 葛琳 汪婷 熊振开 宫磊[3] Zhang Kang;Ge Lin;Wang Ting;Xiong Zhenkai;Gong Lei(Department of Emergency Internal Medicine,Wuhu Hospital of Traditional Chinese Medicine Affiliated to Anhui College of Traditional Chinese Medicine,Wuhu,Anhui,241003,P.R.China;Outpatient Department of Beijing Road Branch of Wuhu Hospital of Traditional Chinese Medicine Affiliated to Anhui College of Traditional Chinese Medicine,Wuhu,Anhui,241003,P.R.China;Medical Biology Teaching and Research Office,Wannan Medical College,Wuhu,Anhui,241002,P.R.China)

机构地区：[1]安徽中医药高等专科学校附属芜湖市中医院急诊内科,安徽芜湖241003 [2]安徽中医药高等专科学校附属芜湖市中医院北京路分院门诊部,安徽芜湖241003 [3]皖南医学院医学生物学教研室,芜湖241002

出　　处：《老年医学与保健》2024年第1期71-77,共7页Geriatrics & Health Care

基　　金：安徽中医药高等专科学校自然科学研究项目(ZRKXY2021F01)。

摘　　要：目的分析老年冠心病患者的心功能分级与本市大气中细颗粒物(PM_(2.5))含量的相关性,并通过体外培养血管内皮细胞,探讨PM_(2.5)是否会导致血管内皮细胞凋亡,并进一步探讨炎症和氧化应激在其中的可能作用和机制。方法本研究分为两部分,第一部分为临床研究,回顾性收集安徽中医药高等专科学校附属芜湖市中医院2021年1月—2022年9月诊断为冠心病的103例老年患者,按照冠心病的心功能分级将其分为1~4级,分析老年冠心病患者的心功能分级与本市大气中PM_(2.5)含量的变化趋势。首先按照冠心病的心功能分级,在心功能<3级和心功能≥3级2组病例中,分别比较PM_(2.5)浓度、血压、糖尿病史、糖化血红蛋白和住院史的差异;其次按照PM_(2.5)浓度分组,在PM_(2.5)<75μg/m^(3)和PM_(2.5)≥75μg/m^(3)2组人群中,分别比较老年冠心病患者的心功能分级、血压、糖尿病史、糖化血红蛋白及住院史的差异。第二部分则通过培养人脐静脉内皮细胞(HUVECs),予以不同浓度梯度的PM_(2.5)干预HUVECs细胞48 h后,Tunel染色检测细胞凋亡情况,荧光显微镜观察ROS的表达与分布,ELISA方法检测SOD活力,RT-PCR方法检测细胞中炎症因子IL-6的mRNA表达。结果第一部分研究结果显示老年冠心病患者的心功能分级与本地区空气中PM_(2.5)的浓度变化趋势一致,且心功能<3级和心功能≥3级2组人群所暴露的大气PM_(2.5)浓度差异有统计学意义(P<0.05)。第二部分研究结果显示不同浓度的PM_(2.5)可诱导HUVECs细胞凋亡;PM_(2.5)呈浓度依赖性地诱导HUVECs细胞中ROS表达和分布增多;并抑制HUVECs细胞的SOD活性(P<0.05);不同浓度PM_(2.5)可诱导HUVECs细胞的炎症因子IL-6 mRNA表达量明显上调(P<0.05)。结论老年冠心病的心功能严重程度与大气中的PM_(2.5)含量高低有关;PM_(2.5)可导致血管内皮细胞凋亡,同时刺激炎症因子表达和氧化应激水平的增加,这可能是Objective To analyze the correlation between the cardiac function grading of elderly patients with coronary heart disease(CHD)and the concentration of fine particulate matter(PM_(2.5))in the atmosphere of this city,explore whether PM_(2.5)can induce apoptosis of vascular endothelial cells by cultured vascular endothelial cells in vitro,and further explore the possible roles and mechanisms of inflammation and oxidative stress in it.Methods This study included two parts.In the first part,103 elderly patients diagnosed with CHD in Wuhu Hospital of Traditional Chinese Medicine Affiliated to Anhui College of Traditional Chinese Medicine from January 2021 to September 2022 were retrospectively collected.According to their heart function grading,they were divided into 14 grading.The heart function grading of elderly CHD patients and the trend of change in PM_(2.5)concentration in the city s atmosphere were analyzed.First,the differences in PM_(2.5)concentration,blood pressure,diabetes history,glycosylated hemoglobin and hospitalization history were compared between the two groups of patients with<3 grading and≥3 grading of heart function according to the cardiac function grading.Secondly,the differences in cardiac function grading,blood pressure,diabetes history,glycosylated hemoglobin and hospitalization history were compared between the PM_(2.5)<75μg/m^(3)group and PM_(2.5)≥75μg/m^(3)group according to PM_(2.5)concentration,respectively.In the second part,human umbilical vein endothelial cells(HUVECs)were cultured.After 48 hours of intervention with different concentration gradients of PM_(2.5)on HUVECs,Tunel staining was used to detect cell apoptosis,fluorescence microscopy was used to observe the expression and distribution of ROS,ELISA method was used to detect SOD activity,and RT-PCR method was used to detect the mRNA expression of inflammatory factor IL-6 in the cells.Results The results of the first part of this study showed that the cardiac function grading of elderly CHD patients was consistent with the

关 键 词：老年 大气中细颗粒物 冠心病 血管内皮细胞 细胞凋亡 氧化应激 

分 类 号：R541.4[医药卫生—心血管疾病]