急性心肌梗死患者PBMC中CSF2RB mRNA和GZMA mRNA表达水平与PCI术后心室重构的关系研究  

Relationship between CSF2RB mRNA and GZMA mRNA Expression Levels in PBMC of Patients with Acute Myocardial Infarction and Ventricular Remodeling after PCI

作　　者：郝翠君 王蕊[1] 洪洋 李晓颖 韩少洁 李方江[1] HAO Cuijun;WANG Rui;HONG Yang;LI Xiaoying;HAN Shaojie;LI Fangjiang(Department of Cardiovascular Medicine,the First Affiliated Hospital of Hebei North University,Hebei Zhangjiakou 075000,China;Department of Clinical Laboratory,the First Affiliated Hospital of Hebei North University,Hebei Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院心血管内科,河北张家口075000 [2]河北北方学院附属第一医院检验科,河北张家口075000

出　　处：《现代检验医学杂志》2025年第2期77-82,共6页Journal of Modern Laboratory Medicine

基　　金：河北省2020年度医学科学研究课题计划(20200509);张家口市2023年市级科技计划自筹项目(2322147D)。

摘　　要：目的探究急性心肌梗死(AMI)患者外周血单个核细胞(PBMC)中集落刺激因子2受体β亚单位(CSF2RB)和颗粒酶A(GZMA)的mRNA表达水平与经皮冠状动脉介入术(PCI)术后心室重构的关系。方法选取2022年2月~2023年8月河北北方学院附属第一医院收治的161例AMI患者作为研究对象,根据是否心室重构进一步分为非重构组(n=105)与重构组(n=56);以同期该院收治的未发生心肌梗死的85例冠心病患者为对照组。收集患者临床资料,实时荧光定量聚合酶链式反应(RT-PCR)法检测PBMC的CSF2RB mRNA,GZMA mRNA水平;超声心动图检测心脏结构参数指标,采用Pearson分析CSF2RB mRNA,GZMA mRNA水平与心脏结构参数的相关性;经单因素、多因素Logistic回归分析AMI患者发生心室重构的影响因素。结果两组CSF2RB mRNA(1.15±0.28 vs 1.80±0.37),GZMA mRNA(0.85±0.16 vs 1.15±0.26)表达及胱抑素C(CysC),同型半胱氨酸(Hcy)水平比较,差异具有统计学意义(t=-39.002~-4.854,均P<0.05)。随访截止2024年8月,161例行PCI术AMI患者中56例发生心室重构;AMI患者中重构组CSF2RB mRNA(1.85±0.31),GZMA mRNA(1.27±0.29)表达水平明显高于非重构组(1.71±0.34,1.12±0.30),差异具有统计学意义(t=2.564,3.057,均P<0.001)。术后AMI患者中重构组左心房内径(LAD)、左心室舒张末内径(LVEDD)、左心室后壁舒张末期厚度(LVPWTd)、室间隔厚度(IVST)均高于非重构组(t=11.247~26.008),左心室射血分数(LVEF)低于重构组(t=-15.271),差异具有统计学意义(均P<0.001)。Pearson相关性分析AMI患者CSF2RB mRNA,GZMA mRNA水平与LAD,LVEDD,LVPWTd,IVST呈正相关(r_(CSF2RB mRNA)=0.657~0.754,r_(GZMA mRNA)=0.512~0.745,均P<0.05),与LVEF呈负相关(r=-0.684,-0.754,均P<0.05)。重构组与非重构组在Cys C和Hcy在使用醛固醇受体拮抗剂水平差异具有统计学意义(t=5.495,20.710,30.906,均P<0.05)。Logistic回归分析显示,CSF2RB mRNA>1.79,GZMA mRNA>1.18,Hcy>20.15μmol/L,未使用醛固醇受体拮抗剂是AMI患者发生Objective To investigate the relationship between the mRNA expression levels of colony stimulating factor 2 receptor subunit beta CSF2RB and granase A(GZMA)in peripheral blood mononuclear cells(PBMC)of patients with acute myocardial infarction(AMI)and ventricular remodeling after percutaneous coronary intervention(PCI).Methods A total of 161 AMI patients admitted to the First Affiliated Hospital of Hebei North University from February 2022 to August 2023 were selected as the study objects,and were further divided into non-remodeling group(n=105)and remodeling group(n=56)according to whether ventricular remodeling was possible.A total of 85 patients with coronary heart disease who did not have myocardial infarction were taken as control group.The clinical data of patients were collected,and the expression levels of CSF2RB and GZMA mRNA in peripheral blood mononuclear cells were detected by real-time fluorescence quantitative PCR.Cardiac structural parameters were detected by echocardiography,and the relationship between CSF2RB and GZMA mRNA levels and cardiac structural parameters was analyzed by Pearson correlation.The influencing factors of ventricular remodeling in AMI patients were analyzed by univariate and Logistic regression,and P<0.05 was considered statistically significant.Results The mRNA expression of CSF2RB(1.15±0.28 vs 1.80±0.37),GZMA(0.85±0.16 vs 1.15±0.26),Cys C and Hcy levels were compared between the two groups,and the differences were statistically significant(t=-39.002~-4.854,all P<0.05).The followup was up to August 2024.Among 161 AMI patients who underwent PCI,56 cases had ventricular remodeling.The expression level of CSF2RB mRNA(1.85±0.31),GZMA mRNA(1.27±0.29)in the reconstructed group were significantly higher than that in the non-reconstructed group(1.71±0.34,1.12±0.30),and the differences were statistically significant(t=2.564,3.057,all P<0.001).LAD,LVEDD,LVPWTd and IVST in the postoperative reconstruction group were higher than those in the nonreconstruction group(t=11.247~26.00

关 键 词：急性心肌梗死 经皮冠状动脉介入 集落刺激因子2受体β亚单位 颗粒酶A 心室重构 

分 类 号：R542.22[医药卫生—心血管疾病] R392.11[医药卫生—内科学]