PLGF和sTie-2与冠状动脉临界病变患者靶血管定量造影特征的相关性研究
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摘要
目的分析胎盘生长因子(PLGF)和可溶酪氨酸激酶受体-2(sTie-2)与冠状动脉(冠脉)临界病变患者靶血管定量造影特征的相关性。方法回顾性分析2016年1月～2018年1月于陕西省第四人民医院心血管内科经冠脉造影证实具有冠脉临界病变的183例患者的临床资料。根据不同的冠脉斑块形态进行分组,其中冠脉粥样硬化(AS)组57例、不稳定型心绞痛(UAP)组71例、稳定型心绞痛(SAP)组55例。分析冠脉造影检查结果,检测血浆PLGF和sTie-2水平;比较三组患者血浆PLGF和sTie-2水平、靶血管定量造影特征、病变范围、形态及易损病变;采用Pearson相关性分析PLGF和sTie-2与靶血管定量造影特征的相关性。结果 UAP组血浆PLGF水平显著高于SAP组和AS组(P<0.05),SAP组与AS组比较,差异无统计学意义(P>0.05);UAP组血浆sTie-2水平显著高于AS组(P<0.05),UAP组与SAP组、SAP组与AS组比较,差异无统计学意义(P>0.05);SAP组靶血管的最小管腔直径、直径狭窄率、最小管腔面积、面积狭窄率与UAP组、AS组比较,差异有统计学意义(P<0.05),UAP组与AS组比较,差异无统计学意义(P>0.05);UAP组斑块面积显著大于AS组(P<0.05),UAP组与SAP组、SAP组与AS组比较,差异无统计学意义(P>0.05);三组患者靶血管的局部病变、偏心病变、光滑病变和易损病变构成比比较,差异有统计学意义(P<0.05);PLGF和sTie-2与靶血管定量造影特征的Pearson相关性分析显示,PLGF与最小管腔面积呈正相关(P<0.05),sTie-2与最小管腔面积、最小管腔直径均呈正相关(P<0.05)。结论冠脉临界病变患者血浆PLGF和sTie-2水平升高,参与斑块内血管新生,与靶血管定量造影特征密切相关,有望成为预测斑块易损性的指标。
Objective To analyze the correlation placental growth factor(PLGF), soluble tyrosine kinase receptor-2(sTie-2) and quantitative angiography features of target vessels in patients with coronary borderline lesions. Methods The clinical data of patients with coronary borderline lesions(n=183) diagnosed by coronary angiography were analyzed in Department of Cardiovascular Medicine in Fourth People's Hospital of Shaanxi Province from Jan. 2016 to Jan. 2018. All patients were divided, according to different coronary plaque morphology, into coronary atherosclerosis group(AS group, n=57), unstable angina pectoris group(UAP group, n=71) and stable angina pectoris group(SAP group, n=55). The results of coronary angiography were analyzed, and levels of plasma PLGF and sTie-2 were detected. The levels of PLGF and sTie-2, quantitative angiography features of target vessels, lesion extent and morphology and vulnerable lesions were compared among 3 groups. The correlation among PLGF, sTie-2 and quantitative angiography features of target vessels were analyzed by using Pearson correlation analysis. Results PLGF level was significantly higher in UAP group than that in SAP group and AS group(P<0.05), and difference in PLGF level had no statistical significance between SAP group and AS group(P>0.05). The level of sTie-2 was significantly higher in UAP group than that in AS group(P<0.05), and difference in sTie-2 level had no statistical significance between UAP group and SAP, and between SAP group and AS(P>0.05). The difference in the minimal lumen diameter(MLD), diameter stenosis rate, minimal lumen area(MLA) and area stenosis rate had statistical significance among SAP group, UAP group and AS group(P<0.05), and the difference had no statistical significance between UAP group and AS group(P>0.05). The plaque area was significantly larger in UAP group than that in AS group(P<0.05), and difference in plaque area had no between UAP group and SAP group, and between SAP group and AS group(P>0.05). The comparison in constituent ratio of target vessel local lesions, eccentric lesion, smooth lesion and vulnerable lesions of target vessels showed that the difference had statistical significance among 3 groups(P<0.05). Pearson correlation analysis showed that PLGF was positively correlated to MLA(P<0.05), and sTie-2 was positively correlated to MLA and MLD(P<0.05). Conclusion The levels of PLGF and sTie-2 increase, take part in angiogenesis in plaques and are closely correlated to quantitative angiography features of target vessels, which are expected to be the indexes for predicting plaque vulnerability.
Objective To analyze the correlation placental growth factor(PLGF), soluble tyrosine kinase receptor-2(sTie-2) and quantitative angiography features of target vessels in patients with coronary borderline lesions. Methods The clinical data of patients with coronary borderline lesions(n=183) diagnosed by coronary angiography were analyzed in Department of Cardiovascular Medicine in Fourth People's Hospital of Shaanxi Province from Jan. 2016 to Jan. 2018. All patients were divided, according to different coronary plaque morphology, into coronary atherosclerosis group(AS group, n=57), unstable angina pectoris group(UAP group, n=71) and stable angina pectoris group(SAP group, n=55). The results of coronary angiography were analyzed, and levels of plasma PLGF and sTie-2 were detected. The levels of PLGF and sTie-2, quantitative angiography features of target vessels, lesion extent and morphology and vulnerable lesions were compared among 3 groups. The correlation among PLGF, sTie-2 and quantitative angiography features of target vessels were analyzed by using Pearson correlation analysis. Results PLGF level was significantly higher in UAP group than that in SAP group and AS group(P<0.05), and difference in PLGF level had no statistical significance between SAP group and AS group(P>0.05). The level of sTie-2 was significantly higher in UAP group than that in AS group(P<0.05), and difference in sTie-2 level had no statistical significance between UAP group and SAP, and between SAP group and AS(P>0.05). The difference in the minimal lumen diameter(MLD), diameter stenosis rate, minimal lumen area(MLA) and area stenosis rate had statistical significance among SAP group, UAP group and AS group(P<0.05), and the difference had no statistical significance between UAP group and AS group(P>0.05). The plaque area was significantly larger in UAP group than that in AS group(P<0.05), and difference in plaque area had no between UAP group and SAP group, and between SAP group and AS group(P>0.05). The comparison in constituent ratio of target vessel local lesions, eccentric lesion, smooth lesion and vulnerable lesions of target vessels showed that the difference had statistical significance among 3 groups(P<0.05). Pearson correlation analysis showed that PLGF was positively correlated to MLA(P<0.05), and sTie-2 was positively correlated to MLA and MLD(P<0.05). Conclusion The levels of PLGF and sTie-2 increase, take part in angiogenesis in plaques and are closely correlated to quantitative angiography features of target vessels, which are expected to be the indexes for predicting plaque vulnerability.
引文
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[14]李超.可溶性生长刺激表达基因2蛋白与急性心肌梗死的研究进展[J].中国循环杂志,2017,32(02):200-2.
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[16]汪雁归,黄佳,杨天伦.急性心肌梗死患者血清循环miR-214水平及其与冠状动脉病变范围的关系[J].中南大学学报(医学版),2015,40(4):362-6.
[17]Pieren M,Prota AE,Ruch C,et al. Crystal structure of the Orf virus NZ2 variant of vascular endothelial growth factor-E. Implications for receptor specificity[J]. J Biol Chem,2006,281(28):19578-87.
[18]马红利,彭瑜,李超,等. sST2参与急性心肌梗死后心肌纤维化[J].中国动脉硬化杂志,2017,25(7):715-8.
[19]周仪华,王舒,袁影.可溶性血管内皮生长因子受体1对动脉粥样硬化斑块的作用[J].中国组织工程研究,2016,20(18):2697-702.
[20]Caillon H,Tardif C,Dumontet E,et al. Evaluation of sFlt-1/PlGF Ratio for Predicting and Improving Clinical Management of Preeclampsia:Experience in a Specialized Perinatal Care Center[J].Ann Lab Med,2018,38(2):95-101.
[2]Donmez E,Koc M,Seker T,et al. The assessment of non culprit coronary artery lesions in patients with ST segment elevated myocardial infarction and multivessel disease by control angiography with quantitative coronary angiography[J]. Int J Cardiovasc Imaging,2016,32(10):1471-6.
[3]龚艳君,胡灏,蒋捷,等.临界病变造影指导与血流储备分数指导的冠状动脉介入治疗策略比较[J].北京大学学报:医学版,2014,46(6):844-7.
[4]Labussière M,Cheneau C,Prahst C,et al. Angiopoietin-2 May Be Involved in the Resistance to Bevacizumab in Recurrent Glioblastoma[J]. Cancer Invest,2016,34(1):39-44.
[5]Austen WG,Edwards JE,Frye RL,et al. A reporting system on patients evaluated for comnary artery disease.Report of Ihe Ad Hoc committee for grading of coronary artery disease,council on cardiovascular surgery,American heart association[J]. Circulation,1975,51(4 Suppl):5-40.
[6]王记远,钱文浩,李文华,等.纤维蛋白原与冠状动脉临界病变血流储备分数的相关性[J].中国动脉硬化杂志,2016,24(12):1234-7.
[7]张惠军,郭喜朝,彭启华,等.急性心肌梗死患者血清胎盘生长因子与近期心功能的关系[J].武警后勤学院学报:医学版,2015(09):700-2.
[8]张仁荣,桂心.冠心病临界病变患者血管因子与冠状动脉斑块形态学特征的相关性研究[J].医学综述,2016,22(10):2038-41.
[9]Lu Y,LüS,Chen Y,et al. A study in the correlation between vascular factors and plaque imaging morphology of coronary borderline lesions in patients with coronary heart disease[J]. Chinese Journal of Emergency Medicine,2015,24(3):267-72.
[10]罗礼云,陈柏荣,黄茵,等.胎盘生长因子对急性心肌梗死大鼠血管新生的影响及心肌保护作用[J].中山大学学报(医学科学版),2016,37(2):222-7.
[11]Fong SW,Few LL,See Too WC,et al. Systemic and coronary levels of CRP, MPO, sCD40L and PlGF in patients with coronary artery disease[J]. BMC Res Notes,2015,8(1):679.
[12]Verlohren S,Herraiz I,Lapaire O,et al. New gestational phase-specific cutoff values for the use of the soluble fms-like tyrosine kinase-1/placental growth factor ratio as a diagnostic test for preeclampsia[J].Hypertension,2014,63(2):346-52.
[13]Findley CM, Mitchell RG, Duscha BD, et al. Plasma Levels of Soluble Tie2 and VEGF Distinguish Critical Limb Ischemia from Intermittent Claudication in Patients with Peripheral Arterial Disease[J]. J Am Coll Cardiol,2008,52(5):387-93.
[14]李超.可溶性生长刺激表达基因2蛋白与急性心肌梗死的研究进展[J].中国循环杂志,2017,32(02):200-2.
[15]Fox CE,Lash GE,Pretlove SJ,et al. Maternal plasma and amniotic fluid angiogenic factors and their receptors in monochorionic twin pregnancies complicated by twin-to-twin transfusion syndrome[J].Ultrasound Obstet&Gynecol,2010,35(6):695-701.
[16]汪雁归,黄佳,杨天伦.急性心肌梗死患者血清循环miR-214水平及其与冠状动脉病变范围的关系[J].中南大学学报(医学版),2015,40(4):362-6.
[17]Pieren M,Prota AE,Ruch C,et al. Crystal structure of the Orf virus NZ2 variant of vascular endothelial growth factor-E. Implications for receptor specificity[J]. J Biol Chem,2006,281(28):19578-87.
[18]马红利,彭瑜,李超,等. sST2参与急性心肌梗死后心肌纤维化[J].中国动脉硬化杂志,2017,25(7):715-8.
[19]周仪华,王舒,袁影.可溶性血管内皮生长因子受体1对动脉粥样硬化斑块的作用[J].中国组织工程研究,2016,20(18):2697-702.
[20]Caillon H,Tardif C,Dumontet E,et al. Evaluation of sFlt-1/PlGF Ratio for Predicting and Improving Clinical Management of Preeclampsia:Experience in a Specialized Perinatal Care Center[J].Ann Lab Med,2018,38(2):95-101.