冠脉内血浆髓过氧化物酶表达水平与冠脉微循环障碍程度的相关性
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摘要
目的:探讨冠状动脉内血浆髓过氧化物酶(MPO)表达水平与冠脉微循环障碍(CMD)程度的相关性。方法:选取2015年1月～2016年8月住院并行经皮冠状动脉介入术(PCI)患者,计算平均血流帧数(平均TFC)。冠脉狭窄程度<40%并伴有慢血流(平均TFC>27)的患者50例纳入冠脉微循环障碍(CMD)组;同时血流正常(平均TFC≤27)的患者50例纳入对照组,检测各组患者冠脉内血浆MPO、一氧化氮(NO)、内皮素-1(ET-1)表达水平。结果:CMD组血浆MPO、ET-1表达水平以及平均TFC均显著高于对照组,NO表达水平显著低于对照组(均P<0.01);Pearson相关性分析结果显示,血浆MPO和ET-1表达水平分别与平均TFC呈显著正相关(均P<0.01),血浆NO表达水平与平均TFC显著负相关(P<0.01)。多因素Logistic回归分析显示,血浆MPO、NO、ET-1与CMD独立相关(P<0.01)。结论:冠脉MPO表达水平与CMD程度相关。
Objective:To investigate the relationship between expression levels of myeloperoxidase in coronary artery and degree of coronary microcirculation disorder.Methods:Selected 100 patients that accepted percutaneous coronary intervention(PCI)therapy when hospitaling from January 2015 to August 2016,their mean TIMI frame counts(mean TFC)were calculated.Those with stenosis degree <40% and coronary slow flow(mean TFC>27)were entered in coronary microcirculation disorder(CMD)group(50 cases),and with normal blood flow(average TFC≤27)in control(CON)group(50 cases).The expressions of MPO,NO and ET-1 in coronary arteries of each group were tested.Results:The expressions of MPO,ET-1 and mean TFC were significantly higher in CMD group than those in CON group,the expression of NO was lower than CON group(all P<0.01).Pearson linear correlation analysis showed that MPO and ET-1 levels were positively correlated with mean TFC and NO level was negatively correlated with mean TFC(P<0.01).Multi-factor Logistic regression analysis showed that the levels of MPO,NO and ET-1 had independent relationship with the degree of CMD(P<0.01).Conclusion:The expression level of MPO was correlated with the degree of CMD.
Objective:To investigate the relationship between expression levels of myeloperoxidase in coronary artery and degree of coronary microcirculation disorder.Methods:Selected 100 patients that accepted percutaneous coronary intervention(PCI)therapy when hospitaling from January 2015 to August 2016,their mean TIMI frame counts(mean TFC)were calculated.Those with stenosis degree <40% and coronary slow flow(mean TFC>27)were entered in coronary microcirculation disorder(CMD)group(50 cases),and with normal blood flow(average TFC≤27)in control(CON)group(50 cases).The expressions of MPO,NO and ET-1 in coronary arteries of each group were tested.Results:The expressions of MPO,ET-1 and mean TFC were significantly higher in CMD group than those in CON group,the expression of NO was lower than CON group(all P<0.01).Pearson linear correlation analysis showed that MPO and ET-1 levels were positively correlated with mean TFC and NO level was negatively correlated with mean TFC(P<0.01).Multi-factor Logistic regression analysis showed that the levels of MPO,NO and ET-1 had independent relationship with the degree of CMD(P<0.01).Conclusion:The expression level of MPO was correlated with the degree of CMD.
引文
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[2]黄文江,黄莺.冠状动脉慢血流研究进展[J].医学综述,2016,22(14):2772-2775.
[3]Dozio E,Barassi A,Marazzi MG,et al.Plasma myeloperoxidase in patients with erectile dysfunction of arteriogenic and non-arteriogenic origin:association with markers of endothelial dysfunction[J].J Biol Regul Homeost Agents,2013,27(3):749-755.
[4]Yunoki K,Naruko T,Komatsu R,et al.Relation of elevated levels of plasma myeloperoxidase to impaired myocardial microcirculation after reperfusion in patients with acute myocardial infarction[J].Am J Cardiol,2010,105(7):922-929.
[5]Gibson CM,Cannon CP,Daley WL,et al.TIMI frame count:a quantitative method of assessing coronary artery flow[J].Circulation,1996,93(5):879-888.
[6]Fineschi M,Coil T.Coronary slow flow phenomenon or syndrome Y:amicrovascular angina awaiting recognition[J].Am Coll Cardiol,2010,56(3):239-240.
[7]Naing Z,Qiu CG.Dawn of the most influential mechanism from the nightmare of slow coronary flow phenomenon:a randomized controlled study[J].Int J Cardiol,2013,168(5):4951-4953.
[8]Luo C,Liu D,Wu G,et al.Effect of enhanced external counterpulsation on coronary slow flow and its relation with endothelial function and inflammation:a midterm follow-up study[J].Cardiology,2012,122(4):260-268.
[9]Kopetz V,Kennedy J,Heresztyn T,et al.Endothelial function,oxidative stress and inflammatory studies in chronic coronary slow flow phenomenon patients[J].Cardiology,2012,121(3):197-203.
[10]Eiserich JP,Baldus S,Brennan ML,et al.Myeloperoxidase,a leukocyte-derived vascular NO oxidase[J].Science,2002,296(5577):2391-2394.
[11]Podrez EA,Abu-Soud HM,Hazen SL.Myeloperoxidase-generated oxidants and atherosclerosis[J].Free Radic Biol Med,2000,28(12):1717-1725.
[12]Olza J,Aguilera CM,Gil-Campos M,et al.Myeloperoxidase is an early biomarker of inflammation and cardiovascular risk in prepubertal obese children[J].Diabetes Care,2012,35(11):2373-2376.
[13]Grigorieva DV,Gorudko IV,Kostevich VA,et al.Myeloperoxidase activity in blood plasma as a criterion of therapy for patients withcardiovascular disease[J].Biomed Khim,2016,62(3):318-324.
[14]Pekdemir H,Polat G,Cin VG,et al.Elevated plasma endothelin-1 levels in coronary sinus during rapid right atrial pacing in patients with slow coronary flow[J].Int JCardiol,2004,97(1):35-41.