冠脉支架内再狭窄患者TLR4基因rs4986790、rs4986791位点多态性及其与临床关系的研究  

Study on rs4986790 and rs4986791 polymorphisms of TLR4 gene in patients with in-stent restenosis and its relationship with clinic

作　　者：黄达[1] 潘兴寿[1] 邹才华[2] 梁烨[3] 李天资[1] 李近都 HUANG Da;PAN Xingshou;ZOU Caihua;LIANG Ye;LI Tianzi;LI Jindu(Department of Cardiovascular Medicine,Affiliated Hospital of Youjiang Medical University for Nationalities,Guangxi,Baise 533000,China;Glandular Surgery,Affiliated Hospital of Youjiang Medical University for Nationalities,Guangxi,Baise 533000,China;Teaching Department,Affiliated Hospital of Youjiang Medical University for Nationalities,Guangxi,Baise 533000,China;Hepatobiliary Pancreatic Splenic Surgery,Guangxi Medical University Cancer Hospital,Guangxi,Nanning 530021,China)

机构地区：[1]右江民族医学院附属医院心血管内科,广西百色533000 [2]右江民族医学院附属医院腺体外科,广西百色533000 [3]右江民族医学院附属医院教学部,广西百色533000 [4]广西医科大学附属肿瘤医院肝胆胰脾外科,广西南宁530021

出　　处：《中国医药科学》2024年第16期141-146,共6页China Medicine And Pharmacy

基　　金：广西壮族自治区卫生健康委员会课题(Z2014525);广西壮族自治区百色市科学技术局科学基金(百科20222940)。

摘　　要：目的 探讨冠脉支架内再狭窄(ISR)患者Toll样受体4(TLR4)外显子基因突变情况及其与临床的关系。方法 选取2019年1月至2022年12月在右江民族医学院附属医院治疗的ISR患者137例,检测体重指数(BMI)、血压、血脂、血糖、血尿酸、C反应蛋白(CRP)、β2微球蛋白(β2MG)、白细胞介素6(IL-6)和TLR4基因rs4986790、rs4986791位点碱基。并与131例同期行冠脉支架植入术支架内无再狭窄(NISR)患者比较。结果 ISR组患者BMI、收缩压、总胆固醇、甘油三酯、空腹血糖、血尿酸、CRP、β2MG和IL-6水平高于NISR组(P <0.05);ISR组TLR4基因rs4986790位点碱基突变率高于NISR组(P <0.05),TLR4基因rs4986791位点碱基突变率高于NISR组(P <0.05);TLR4基因突变表型组BMI、收缩压、总胆固醇、甘油三酯、空腹血糖、血尿酸、CRP、β2MG和IL-6水平高于TLR4野生表型组(P <0.05)。结论 冠脉支架内再狭窄患者TLR4基因外显子突变率高,TLR4基因外显子突变的患者其代谢和炎症因子异常情况有叠加作用。Objective To investigate the mutation of Toll-like receptors 4(TLR4)exon gene in patients with instent restenosis(ISR)and its relationship with clinic.Methods A total of 137 patients with ISR who were treated in the Affiliated Hospital of Youjiang Medical University for Nationalities from January 2019 to December 2022 were selected,and their body mass index(BMI),blood pressure,blood lipid,blood glucose,blood uric acid,C-reactive protein(CRP),β2 microglobulin(β2MG),interleukin 6(IL-6)and TLR4 gene rs4986790,rs4986791 locus bases were detected.The results were compared with 131 patients with no in-stent restenosis(NISR)who underwent coronary stent implantation at the same time.Results The levels of BMI,systolic blood pressure,total cholesterol,triglyceride,fasting blood glucose,blood uric acid,CRP,β2MG and IL-6 in ISR group were higher than those in NISR group(P<0.05).The rs4986790 mutation rate of TLR4 gene in ISR group was higher than that in NISR group(P<0.05),and the rs4986791 mutation rate of TLR4 gene in ISR group was higher than that in NISR group(P<0.05).The levels of BMI,systolic blood pressure,total cholesterol,triglyceride,fasting blood glucose,blood uric acid,CRP,β2MG and IL-6 in TLR4 mutant group were higher than those in TLR4 wild group(P<0.05).Conclusion Patients with in-stent restenosis have a high mutation rate of TLR4 gene exon,and patients with TLR4 gene exon mutation have a superposition effect on metabolic and inflammatory factors abnormalities.

关 键 词：冠状动脉狭窄 介入治疗反应 支架内再狭窄 Toll受体4 基因突变 

分 类 号：R541.4[医药卫生—心血管疾病]