冠心病患者外周血血小板Nox2蛋白与冠脉病变程度的关系
发布时间：2018-08-22 13:44
【摘要】：背景调查研究发现,冠状动脉粥样硬化性心脏病的患病率逐年上升,且年轻化趋势愈加明显。已经有越来越多的权威研究报道证实,人体内相关炎症反应参与了冠脉粥样硬化病变的始发过程。还原型烟酰胺腺嘌呤二核苷酸磷酸氧化酶(Nicotinamide adenine dinucleotide phosphate oxidase,NOX)是机体细胞内富有氧化活性的蛋白质,其家族中的某些亚型被视为动脉粥样硬化病变进展过程中的重要调节因子。NOX在血小板、吞噬细胞和心血管细胞中均有表达,NOX参与了心血管系统诸多功能的调节,例如细胞分化、增殖等生理过程,同时参与炎症反应和氧化应激等病理过程。NOX某些亚型尤其是Nox2与高血压病、血管侧支形成、动脉粥样硬化病变等紧密相关。内皮细胞表达的Nox2可增加超氧化合物的产生,促进吞噬细胞集聚于动脉血管早期病变处。最新研究证实,Nox2可以增加血小板活性,从而促进血小板聚集,最终促进血小板依赖的血栓生成。目的通过检测血小板Nox2蛋白的表达水平,初步判断其对冠心病的诊断价值;探讨血小板Nox2蛋白与冠脉粥样硬化病变程度的关系;进而通过检测血小板Nox2蛋白初步判定冠状动脉病变程度,为冠心病患者冠脉病变严重程度提供一定的理论依据。方法按入选标准,需符合WHO初治CHD的诊断标准,选取选取2015年8月-2016年2月由新乡医学院一附院心血管内科收治的初治CHD且入院后行冠状动脉介入诊疗的患者81例,其中男性42女性39例。排除标准:住院期间诊断患急、慢性肝肾肾功能不全;全身任何一个或多个系统的恶性肿瘤;患有血液系统疾病患者;口服抗血小板药物史患者。依照冠脉造影诊断,冠脉正常组22例;冠脉病变组59例,其中轻、中、重度狭窄组分别有13例、18例和28例。入选患者临床资料,高血压病和糖尿病病史等。血生化检测血脂指标、血同型半胱氨酸(HCY);补体C3、C4。血小板Nox2蛋白表达水平采用Western-blot方法检测。所有入选患者均知情同意并签署知情同意书。结果冠状动脉病变组高血压病、糖尿病患者的比例及TG、LDL-C、HCY的含量均高于冠状动脉正常组(P0.05),HDL-C低于冠脉正常组(P0.05)。冠脉病变组血小板Nox2高于正常组(P0.05),冠状动脉病变组中补体C3和补体C4的水平高于冠状动脉正常组(P0.05)。冠状动脉中度、重度病变患者血小板Nox2蛋白的表达水平升高(P0.01);血小板Nox2蛋白表达水平与冠脉病变严重程度呈正相关。血小板Nox2蛋白与补体C3、C4的浓度呈正相关。结论1.血小板Nox2蛋白的表达水平对冠心病的诊断有一定的价值,且与冠脉粥样硬化病变严重程度呈正相关。2.血小板Nox2蛋白很可能与补体C3、C4存在协同作用,共同参与了冠脉粥样病变的发生以及发展过程。
[Abstract]:Background study found that the prevalence of coronary atherosclerotic heart disease increased year by year, and the trend of younger. More and more authoritative research reports have confirmed that inflammation in human body is involved in the initiation of coronary atherosclerosis. Reduced nicotinamide adenine dinucleotide phosphatase oxidase (Nicotinamide adenine dinucleotide phosphate oxidase) is an oxidizing protein in cells. Some subtypes in the family are considered to be important regulatory factors in the progression of atherosclerosis. NOX is expressed in platelets, phagocytes and cardiovascular cells, and is involved in many cardiovascular system functions, such as cell differentiation. Proliferation and other physiological processes, including inflammation and oxidative stress. Some subtypes of NOX, especially Nox2, are closely related to hypertension, vascular collateral formation, atherosclerosis and so on. The expression of Nox2 in endothelial cells can increase the production of superoxide compounds and promote the accumulation of phagocytes in the early lesions of arterial vessels. Recent studies have shown that Nox2 can increase platelet activity, promote platelet aggregation, and ultimately promote platelet dependent thrombogenesis. Objective to determine the value of platelet Nox2 protein expression in the diagnosis of coronary heart disease and to explore the relationship between platelet Nox2 protein and the degree of coronary atherosclerosis. Furthermore, the degree of coronary artery disease was determined by detecting platelet Nox2 protein, which provided a theoretical basis for the severity of coronary artery disease in patients with coronary heart disease. Methods according to the inclusion criteria, 81 patients with newly diagnosed CHD who were admitted to the Department of Cardiovascular Medicine of the first affiliated Hospital of Xinxiang Medical College from August 2015 to February 2016 and received coronary intervention were selected according to the diagnostic criteria of WHO CHD. Among them, 42 cases were male and 39 cases were female. Exclusion criteria: diagnosis of acute, chronic liver and kidney insufficiency; malignant neoplasms of any or more systems throughout the body; patients with hematological diseases; patients with oral antiplatelet drug history. According to coronary angiography, there were 22 cases in normal coronary artery group and 59 cases in coronary artery disease group, including 13 cases of mild, moderate and severe stenosis group and 28 cases of coronary artery disease group, respectively. Clinical data, history of hypertension and diabetes were selected. The blood lipid index and serum homocysteine (HCY); complement C _ 3 C _ 4 were detected. The expression of platelet Nox2 protein was detected by Western-blot. All patients were informed consent and signed informed consent. Results the proportion of patients with hypertension and diabetes mellitus and the content of TGN LDL-CHCY in coronary artery disease group were higher than those in normal coronary artery group (P0.05) and HDL-C was lower than that in normal coronary artery group (P0.05). The levels of complement C _ 3 and complement C _ 4 in coronary artery lesion group were higher than those in normal coronary artery group (P0.05). The expression level of platelet Nox2 protein was increased in patients with moderate and severe coronary artery disease (P0.01), and the expression level of platelet Nox2 protein was positively correlated with the severity of coronary artery disease. There was a positive correlation between platelet Nox2 protein and complement C _ 3 C _ 4 concentration. Conclusion 1. The expression of platelet Nox2 protein has certain value in the diagnosis of coronary heart disease, and it is positively correlated with the severity of coronary atherosclerosis. Platelet Nox2 protein may have synergistic effect with complement C _ 3N _ 4, and participate in the occurrence and development of coronary atherosclerosis.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.4
[Abstract]:Background study found that the prevalence of coronary atherosclerotic heart disease increased year by year, and the trend of younger. More and more authoritative research reports have confirmed that inflammation in human body is involved in the initiation of coronary atherosclerosis. Reduced nicotinamide adenine dinucleotide phosphatase oxidase (Nicotinamide adenine dinucleotide phosphate oxidase) is an oxidizing protein in cells. Some subtypes in the family are considered to be important regulatory factors in the progression of atherosclerosis. NOX is expressed in platelets, phagocytes and cardiovascular cells, and is involved in many cardiovascular system functions, such as cell differentiation. Proliferation and other physiological processes, including inflammation and oxidative stress. Some subtypes of NOX, especially Nox2, are closely related to hypertension, vascular collateral formation, atherosclerosis and so on. The expression of Nox2 in endothelial cells can increase the production of superoxide compounds and promote the accumulation of phagocytes in the early lesions of arterial vessels. Recent studies have shown that Nox2 can increase platelet activity, promote platelet aggregation, and ultimately promote platelet dependent thrombogenesis. Objective to determine the value of platelet Nox2 protein expression in the diagnosis of coronary heart disease and to explore the relationship between platelet Nox2 protein and the degree of coronary atherosclerosis. Furthermore, the degree of coronary artery disease was determined by detecting platelet Nox2 protein, which provided a theoretical basis for the severity of coronary artery disease in patients with coronary heart disease. Methods according to the inclusion criteria, 81 patients with newly diagnosed CHD who were admitted to the Department of Cardiovascular Medicine of the first affiliated Hospital of Xinxiang Medical College from August 2015 to February 2016 and received coronary intervention were selected according to the diagnostic criteria of WHO CHD. Among them, 42 cases were male and 39 cases were female. Exclusion criteria: diagnosis of acute, chronic liver and kidney insufficiency; malignant neoplasms of any or more systems throughout the body; patients with hematological diseases; patients with oral antiplatelet drug history. According to coronary angiography, there were 22 cases in normal coronary artery group and 59 cases in coronary artery disease group, including 13 cases of mild, moderate and severe stenosis group and 28 cases of coronary artery disease group, respectively. Clinical data, history of hypertension and diabetes were selected. The blood lipid index and serum homocysteine (HCY); complement C _ 3 C _ 4 were detected. The expression of platelet Nox2 protein was detected by Western-blot. All patients were informed consent and signed informed consent. Results the proportion of patients with hypertension and diabetes mellitus and the content of TGN LDL-CHCY in coronary artery disease group were higher than those in normal coronary artery group (P0.05) and HDL-C was lower than that in normal coronary artery group (P0.05). The levels of complement C _ 3 and complement C _ 4 in coronary artery lesion group were higher than those in normal coronary artery group (P0.05). The expression level of platelet Nox2 protein was increased in patients with moderate and severe coronary artery disease (P0.01), and the expression level of platelet Nox2 protein was positively correlated with the severity of coronary artery disease. There was a positive correlation between platelet Nox2 protein and complement C _ 3 C _ 4 concentration. Conclusion 1. The expression of platelet Nox2 protein has certain value in the diagnosis of coronary heart disease, and it is positively correlated with the severity of coronary atherosclerosis. Platelet Nox2 protein may have synergistic effect with complement C _ 3N _ 4, and participate in the occurrence and development of coronary atherosclerosis.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.4
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