急性心肌梗死PCI术后HF患者外周血NLRP3、Caspase⁃1、IL⁃1β的表达及意义  

Expression and significance of NLRP3,Caspase⁃1 and IL⁃1βin peripheral blood of HF patients with acute myocardial infarction after PCI

作　　者：付振强 安松涛 孙国举[3] 吴帆 FU Zhenqiang;AN Songtao;SUN Guoju;WU Fan(Department of Cardiovascular Medicine,Xuchang Hospital,Xuchang,Henan,China,461001;Depart-ment of Cardiovascular Medicine,Fuwai Central China Cardiovascular Hospital,Zhengzhou,Henan,China,451450;Department of Cardiovascular Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan,China,450000;Department of Cardiovascular Medicine,Xuchang Central Hospital,Xuchang,Henan,China,461001)

机构地区：[1]许昌医院心血管内科,河南许昌461001 [2]阜外华中心血管病医院心血管内科,河南郑州451450 [3]郑州大学第一附属医院心血管内科,河南郑州450000 [4]许昌市中心医院心血管内科,河南许昌461001

出　　处：《分子诊断与治疗杂志》2024年第11期2130-2134,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20191389)。

摘　　要：目的探讨急性心肌梗死(AMI)经皮冠状动脉介入治疗(PCI)术后心力衰竭(HF)患者外周血核苷酸寡聚化结构域样受体热蛋白结构域相关蛋白3(NLRP3)、半胱氨酸天门冬氨酸蛋白水解酶⁃1(Caspase⁃1)、白细胞介素⁃1β(IL⁃1β)的表达及意义。方法选取许昌医院2018年5月至2023年5月收治的82例接受PCI术的AMI患者,根据术后是否发生HF将其分为HF组(33例)与非HF组(49例)。比较两组外周血NLRP3、Caspase⁃1、IL⁃1β的mRNA表达水平以及超声心动图指标[左心室射血分数(LVEF)、左室峰射血率时间(LVT⁃PER)、左室峰射血率(LVPER)]、心肌损伤标志物[肌酸激酶同工酶(CK⁃MB)、肌钙蛋白Ⅰ(cTnⅠ)、肌红蛋白(Mb)]。分析外周血NLRP3、Caspase⁃1、IL⁃1β表达水平与超声心动图指标、心肌损伤标志物的相关性,以及对AMI患者PCI术后HF发生的预测价值。结果HF组外周血NLRP3、Caspase⁃1、IL⁃1β的mRNA水平均高于非HF组,差异有统计学意义(P<0.05)。AMI患者外周血NLRP3、Caspase⁃1、IL⁃1β水平之间均存在显著正相关性(P<0.05)。HF组LVEF、LVT⁃PER均低于非HF组,LVPER、CK⁃MB、cTnⅠ、Mb均高于非HF组,差异有统计学意义(P<0.05)。AMI患者外周血NLRP3、Caspase⁃1、IL⁃1β水平与LVEF、LVT⁃PER存在显著负相关性,与LVPER、CK⁃MB、cTnⅠ、Mb存在显著正相关性(P<0.05)。ROC曲线分析显示,外周血NLRP3、Caspase⁃1、IL⁃1β以及联合对AMI患者PCI术后HF发生均有预测效能(P<0.05),其AUC分别为0.800、0.930、0.978、0.994,其中联合效能最高,敏感性为96.97%,特异性为95.92%。结论PCI术后发生HF的AMI患者外周血NLRP3、Caspase⁃1、IL⁃1β表达增加,三指标可预测术后HF发生,且联合预测效能最高。Objective To explore the expression and significance of nucleotide⁃binding oligomerization domain⁃like receptor protein 3(NLRP3),cysteine aspartate proteolytic enzyme⁃1(Caspase⁃1)and interleukin⁃1β(IL⁃1β)in peripheral blood of patients with heart failure after percutaneous coronary intervention(PCI)for acute myocardial infarction(AMI).Methods 82 patients with AMI who underwent PCI at Xuchang Hospital from May 2018 to May 2023 were selected.They were divided into two groups:the HF group(33 cases)and the non⁃HF group(49 cases)based on whether HF occurred after surgery.The mRNA expression levels of peripheral blood NLRP3,Caspase⁃1 and IL⁃1βas well as echocardiographic indicators(left ventricular ejection fraction(LVEF),left ventricular time to peak ejection rate(LVT⁃PER),left ventricular peak ejection rate(LVPER)and myocardial injury markers creatine kinase isoenzyme(CK⁃MB),cardiac troponin(cTnI),myoglobin(Mb)were compared between both groups.The correlation between the expression levels of peripheral blood NLRP3,Caspase⁃1 and IL⁃1βand echocardiographic indicators and myocardial injury markers,as well as the predictive value for the occurrence of HF in patients with AMI after PCI were analyzed.Results The mRNA levels of peripheral blood NLRP3,Caspase⁃1,and IL⁃1βin the HF group were higher than those in the non⁃HF group(P<0.05).There was a significant positive correlation among the levels of peripheral blood NLRP3,caspase⁃1,and IL⁃1βin patients with AMI(P<0.05).LVEF and LVT⁃PER in the HF group were lower than those in the non⁃HF group while LVPER,CK⁃MB,cTnI,and Mb were higher than those in the non⁃HF group(P<0.05).The levels of NLRP3,Caspase⁃1,and IL⁃1βin the peripheral blood of patients with AMI were significantly negatively correlated with LVEF and LVT⁃PER,and significantly positively correlated with LVPER,CK⁃MB,cTnI,and Mb(P<0.05).ROC curve analysis revealed that peripheral blood NLRP3,Caspase⁃1,IL⁃1β,and their combination had predictive efficiency on

关 键 词：急性心肌梗死 经皮冠状动脉介入治疗 心力衰竭 核苷酸寡聚化结构域样受体热蛋白结构域相关蛋白3 半胱氨酸天门冬氨酸蛋白水解酶⁃1 白细胞介素⁃1β 

分 类 号：R542.22[医药卫生—心血管疾病]