组织型纤溶酶原激活物-抑制剂复合物(t-PAIC)在冠心病患者中表达变化及与预后相关性分析
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摘要
目的:探讨组织型纤溶酶原激活物-抑制剂复合物(t-PAIC)在冠心病患者中表达变化及与预后相关性分析。方法:选择2016年4月至2017年12月我院检验科收治的173例冠心病患者及非冠心病患者50例进行本次研究。根据临床症状、心电图表现、心肌酶指标、冠状动脉造影等结果,将冠心病患者分为不稳定性心绞痛组(n=103)、稳定性心绞痛组(n=70)。再根据冠状动脉造影结果,分为单支血管病变组(n=38)、双支血管病变组(n=64)及三支血管病变组(n=71)。探讨t-PAIC在冠心病患者中表达变化及与预后相关性分析。结果:不稳定性心绞痛组患者的肌酸激酶同工酶(CKMB)、总胆固醇(TC)、C反应蛋白(CRP)、空腹血糖(FBG)均高于稳定性心绞痛组和非冠心病组(P<0.05);稳定性心绞痛组的CKMB、CRP均高于非冠心病组(P<0.05)。不稳定性心绞痛组的血浆组织型纤溶酶原激活物抑制剂1(PAI-1)浓度高于稳定性心绞痛组和非冠心病组,而前者的血浆组织型纤溶酶原激活物(t-PA)浓度低于后两者,差异均有统计学意义(P<0.05);稳定性心绞痛组的血浆PAI-1浓度高于非冠心病组,血浆t-PA浓度低于后者,差异均有统计学意义(P<0.05)。非冠心病组、单支血管病变组、双支血管病变组、三支血管病变组的血浆PAI-1浓度依次升高,而血浆t-PA浓度依次降低,且组间比较,差异均具有统计学意义(P<0.05)。结论:t-PAIC浓度与冠脉狭窄数、疾病严重程度呈相关性,可作为临床上预测冠心病患者预后的血清学指标。
Objective: To analyze expression of tissue plasminogen activator inhibitor complex(t-PAIC) in patients with coronary heart disease and its correlation with prognosis. Methods: From April 2016 to December 2017, 173 patients with coronary heart disease and 50 patients without coronary heart disease were selected for this study. Firstly, according to clinical symptoms, electrocardiogram, myocardial enzyme index and coronary angiography, patients with coronary heart disease were divided into unstable angina pectoris group(n=103), stable angina pectoris group(n=70). Secondly, according to the results of coronary angiography, they were divided into single vessel disease group(n=38), double vessel disease group(n=64) and three vessel disease group(n=71). To analyze expression of t-PAIC in patients with coronary heart disease and its correlation with prognosis. Results: The levels of CKMB, TC, CRP, FBG in unstable angina pectorts group were higher than those in stable angina pectoris group and non-coronary heart disease group(P<0.05). The levels of CKMB, CRP in stable angina pectoris group were higher than those in non-coronary heart disease group(P<0.05). The plasma concentration of plasminogen activator inhibitor 1(PAI-1) of unstable angina pectoris group was higher than that of stable angina pectoris group and non-coronary heart disease group, while the plasma concentration of tissue plasminogen activator(t-PA) of unstable angina pectoris group was lower than that of stable angina pectoris group and non-coronary heart disease group(P<0.05). The plasma concentration of PAI-1 of stable angina pectoris group was higher than that of non-coronary heart disease group, and the plasma concentration of t-PA was lower than that of non-coronary heart disease group(P<0.05). The plasma concentration of PAI-1 in non-coronary heart disease group, single vessel disease group, double vessel disease group and three vessel disease group increased in turn, while the plasma concentration of t-PA decreased accordingly, and the difference between groups was statistically significant(P<0.05). Conclusion: Plasma t-PAIC concentration is positively correlated with the number of coronary stenosis and the severity of the disease. It can be used as a serological index to predict the prognosis of patients with coronary heart disease.
Objective: To analyze expression of tissue plasminogen activator inhibitor complex(t-PAIC) in patients with coronary heart disease and its correlation with prognosis. Methods: From April 2016 to December 2017, 173 patients with coronary heart disease and 50 patients without coronary heart disease were selected for this study. Firstly, according to clinical symptoms, electrocardiogram, myocardial enzyme index and coronary angiography, patients with coronary heart disease were divided into unstable angina pectoris group(n=103), stable angina pectoris group(n=70). Secondly, according to the results of coronary angiography, they were divided into single vessel disease group(n=38), double vessel disease group(n=64) and three vessel disease group(n=71). To analyze expression of t-PAIC in patients with coronary heart disease and its correlation with prognosis. Results: The levels of CKMB, TC, CRP, FBG in unstable angina pectorts group were higher than those in stable angina pectoris group and non-coronary heart disease group(P<0.05). The levels of CKMB, CRP in stable angina pectoris group were higher than those in non-coronary heart disease group(P<0.05). The plasma concentration of plasminogen activator inhibitor 1(PAI-1) of unstable angina pectoris group was higher than that of stable angina pectoris group and non-coronary heart disease group, while the plasma concentration of tissue plasminogen activator(t-PA) of unstable angina pectoris group was lower than that of stable angina pectoris group and non-coronary heart disease group(P<0.05). The plasma concentration of PAI-1 of stable angina pectoris group was higher than that of non-coronary heart disease group, and the plasma concentration of t-PA was lower than that of non-coronary heart disease group(P<0.05). The plasma concentration of PAI-1 in non-coronary heart disease group, single vessel disease group, double vessel disease group and three vessel disease group increased in turn, while the plasma concentration of t-PA decreased accordingly, and the difference between groups was statistically significant(P<0.05). Conclusion: Plasma t-PAIC concentration is positively correlated with the number of coronary stenosis and the severity of the disease. It can be used as a serological index to predict the prognosis of patients with coronary heart disease.
引文
[1] 李妍,曾欧,李琳,等.冠心病患者血清CysC、Lp-PLA2、MMP-9、PAI-1水平变化及临床意义[J].山东医药,2016,6(33):5-7.
[2] 张浩,徐兵,李泽浦.奥扎格雷对不稳定心绞痛患者血小板CD63、CD62P表达及血浆PAI-1、C-RP含量的影响[J].实用临床医药杂志,2012,16(11):85-87.
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[8] 蒋守涛,黄华,陈蓓蓓,等.参芎注射液对不稳定型心绞痛患者PAI 1表达的影响[J].中西医结合心脑血管病杂志,2015,10(15):1754-1755.
[9] Iida K,Tani S,Atsumi W,et al.Association of plasminogen activator inhibitor-1 and low-density lipoprotein heterogeneity as a risk factor of atherosclerotic cardiovascular disease with triglyceride metabolic disorder:a pilot cross-sectional study[J].Coron Artery Dis,2017,28(7):577-587.
[10] Song C,Burgess S,Eicher JD,et al.Causal effect of plasminogen activator inhibitor type 1 on coronary heart disease[J].J Am Heart Assoc,2017,6(6).pii:e004918.
[11] 卢思稼.PAI-1在老年女性冠心病患者中的表达[J].中西医结合心脑血管病杂志,2014,12(3):373.
[12] Chengji W,Xianjin F.Treadmill exercise alleviates diabetic cardiomyopathy by suppressing plasminogen activator inhibitor expression and enhancing eNOS in streptozotocin-induced male diabetic rats[J].Endocr Connect,2018,7(4):553-559.
[13] Gilliot S,Sibon I,Mas JL,et al.Influence of on-going treatment with angiotensin-converting enzyme inhibitor or angiotensin receptor blocker on the outcome of patients treated with intravenous rt-PA for ischemic stroke[J].J Neurol,2018,265(5):1166-1173.
[14] 戚德清,许康世.GPⅡb基因型急性心肌梗死患者介入治疗前后GMP-140、vWF和PAI-1水平[J].贵阳医学院学报,2014,13(1):57-60.
[15] Chan SL,Bishop N,Li Z,et al.Inhibition of PAI (plasminogen activator inhibitor)-1 improves brain collateral perfusion and injury after acute ischemic stroke in aged hypertensive rats[J].Stroke,2018,49(8):1969-1976.
[16] 章怡祎,刘萍,励冬斐,等.冠心康对ApoE基因敲除小鼠动脉粥样硬化的影响[J].上海中医药杂志,2012,15(11):80-83.
[17] Pavlov M,Nikolic-Heitzler V,Babic Z,et al.Plasminogen activator inhibitor-1 activity and long-term outcome in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention:a prospective cohort study[J].Croat Med J,2018,59 (3):108-117.
[18] 古孜丽努尔-吐尼亚孜,哈斯也提-依部来音.丹参酮治疗老年冠心病的疗效及对血脂和血清 t-PA、PAI-1的影响[J].现代中西医结合杂志,2016,7(23):2561-2563.
[19] Li B,Hu J,Chen X.MicroRNA-30b protects myocardial cell function in patients with acute myocardial ischemia by targeting plasminogen activator inhibitor-1[J].Exp Ther Med,2018,15(6):5125-5132.
[2] 张浩,徐兵,李泽浦.奥扎格雷对不稳定心绞痛患者血小板CD63、CD62P表达及血浆PAI-1、C-RP含量的影响[J].实用临床医药杂志,2012,16(11):85-87.
[3] Jung RG,Simard T,Labinaz A,et al.Role of plasminogen activator inhibitor-1 in coronary pathophysiology[J].Thromb Res,2018,164(4):54-62.
[4] Tang J,Zhu W,Mei X,et al.Plasminogen activator inhibitor-1:a risk factor for deep vein thrombosis after total hip arthroplasty[J].J Orthop Surg Res,2018,13(1):8.
[5] 詹莉,关秀军,邓斌.PAI-1与AMI患者冠状动脉内血栓形成溶栓后及复通的关系[J].心脏杂志,2016,8(6):711-713.
[6] 李琳,李芳,肖婷,等.冠心病患者外周血RANTES、PAI-1和ADMA水平的变化及与GRACE评分的相关性分析[J].临床检验杂志,2015,9(8):577-580.
[7] Gonias SL,Banki MA,Gilder AS,et al.PAI1 blocks NMDA receptor-mediated effects of tissue-type plasminogen activator on cell signaling and physiology[J].J Cell Sci,2018,131(14).pii:jcs217083.
[8] 蒋守涛,黄华,陈蓓蓓,等.参芎注射液对不稳定型心绞痛患者PAI 1表达的影响[J].中西医结合心脑血管病杂志,2015,10(15):1754-1755.
[9] Iida K,Tani S,Atsumi W,et al.Association of plasminogen activator inhibitor-1 and low-density lipoprotein heterogeneity as a risk factor of atherosclerotic cardiovascular disease with triglyceride metabolic disorder:a pilot cross-sectional study[J].Coron Artery Dis,2017,28(7):577-587.
[10] Song C,Burgess S,Eicher JD,et al.Causal effect of plasminogen activator inhibitor type 1 on coronary heart disease[J].J Am Heart Assoc,2017,6(6).pii:e004918.
[11] 卢思稼.PAI-1在老年女性冠心病患者中的表达[J].中西医结合心脑血管病杂志,2014,12(3):373.
[12] Chengji W,Xianjin F.Treadmill exercise alleviates diabetic cardiomyopathy by suppressing plasminogen activator inhibitor expression and enhancing eNOS in streptozotocin-induced male diabetic rats[J].Endocr Connect,2018,7(4):553-559.
[13] Gilliot S,Sibon I,Mas JL,et al.Influence of on-going treatment with angiotensin-converting enzyme inhibitor or angiotensin receptor blocker on the outcome of patients treated with intravenous rt-PA for ischemic stroke[J].J Neurol,2018,265(5):1166-1173.
[14] 戚德清,许康世.GPⅡb基因型急性心肌梗死患者介入治疗前后GMP-140、vWF和PAI-1水平[J].贵阳医学院学报,2014,13(1):57-60.
[15] Chan SL,Bishop N,Li Z,et al.Inhibition of PAI (plasminogen activator inhibitor)-1 improves brain collateral perfusion and injury after acute ischemic stroke in aged hypertensive rats[J].Stroke,2018,49(8):1969-1976.
[16] 章怡祎,刘萍,励冬斐,等.冠心康对ApoE基因敲除小鼠动脉粥样硬化的影响[J].上海中医药杂志,2012,15(11):80-83.
[17] Pavlov M,Nikolic-Heitzler V,Babic Z,et al.Plasminogen activator inhibitor-1 activity and long-term outcome in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention:a prospective cohort study[J].Croat Med J,2018,59 (3):108-117.
[18] 古孜丽努尔-吐尼亚孜,哈斯也提-依部来音.丹参酮治疗老年冠心病的疗效及对血脂和血清 t-PA、PAI-1的影响[J].现代中西医结合杂志,2016,7(23):2561-2563.
[19] Li B,Hu J,Chen X.MicroRNA-30b protects myocardial cell function in patients with acute myocardial ischemia by targeting plasminogen activator inhibitor-1[J].Exp Ther Med,2018,15(6):5125-5132.