[1]蒋红英,王依阳,赵 慧,等.冠心病PCI 术后患者血液FIB，NLRP3 和LECT-2 水平表达与冠状动脉微血管疾病发生的相关性研究[J].现代检验医学杂志,2023,38(06):35-41.[doi:10.3969/j.issn.1671-7414.2023.06.007]
　JIANG Hongying,WANG Yiyang,ZHAO Hui,et al.Correlation between Blood FIB, NLRP3 and LECT-2 Expression Levels and the Development of Coronary Microvascular Disease in Patients with Coronary Artery Disease after PCI[J].Journal of Modern Laboratory Medicine,2023,38(06):35-41.[doi:10.3969/j.issn.1671-7414.2023.06.007]
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冠心病PCI 术后患者血液FIB，NLRP3 和LECT-2 水平表达与冠状动脉微血管疾病发生的相关性研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年06期
页码:
35-41
栏目:
论著
出版日期:
2023-11-15

文章信息/Info

Title:
Correlation between Blood FIB, NLRP3 and LECT-2 Expression Levels and the Development of Coronary Microvascular Disease in Patients with Coronary Artery Disease after PCI
文章编号:
1671-7414（2023）06-035-07
作者:
蒋红英1; 王依阳1; 赵 慧1; 梁宸源1; 姜瑞嘉1; 任园园1; 陈 亮1; 许百灵2; 程 功1
（1. 陕西省人民医院心血管内科，西安 710068；2. 美国密苏里哥伦比亚大学- 核科学暨工程研究所，密苏里州MO 65211）
Author(s):
JIANG Hongying1;  WANG Yiyang1;  ZHAO Hui1;  LIANG Chenyuan1;  JIANG Ruijia1;  REN Yuanyuan1;  CHEN Liang1;  XU Bailing2;  CHENG Gong1
（1.Department of Cardiology, Shaanxi Provincial People’s Hospital, Xi’an 710068, China; 2. Institute of Nuclear Science and Engineering-Columbia University of Missouri, U S A, Missouri MO 65211, USA）
关键词:
冠状动脉微血管疾病; 纤维蛋白原; 核苷酸结合寡聚化结构域样受体蛋白3; 白细胞衍生趋化因子2
分类号:
R541.4；R392.11
DOI:
10.3969/j.issn.1671-7414.2023.06.007
文献标志码:
A
摘要:
目的 探究冠心病经皮冠状动脉介入(percutaneous coronary intervention，PCI) 术后患者血液纤维蛋白原(fibrinogen，FIB)、核苷酸结合寡聚化结构域样受体蛋白3(nucleotide-binding oligomerization domain-like receptor protein3，NLRP3) 和白细胞衍生趋化因子2(leukocyte cell-derived chemotaxin 2，LECT-2) 与冠状动脉微血管疾病(coronarymicrovascular disease，CMVD) 发生的相关性。方法 收集 2021 年 7 月～ 2022 年 9 月冠心病PCI 术后仍有心肌缺血相关症状就诊于陕西省人民医院心内科的患者，冠状动脉造影或冠脉CT 血管成像检查提示心外膜冠脉狭窄直径<50%，根据单电子发射计算机断层成像(single-photon emission computer tomography，SPECT) 检查测定冠状动脉血流储备(coronary flow reserve，CFR) ，分为CMVD 组(CFR<2.0，n=78) 和对照组(CFR ≥ 2.0，n=47)。检测血液FIB，血小板与淋巴细胞比值(platelet to lymphocyte ratio, PLR)，糖化血红蛋白（HbA1c），NLRP3 和LECT-2 水平，分析其与冠心病PCI 术后CMVD 发生的相关性。绘制受试者工作特征(receiver operating characteristic，ROC) 曲线，评价血液FIB，PLR，HbA1c，NLRP3 和LECT-2 对冠心病PCI 术后CMVD 发生的预测价值。结果 与对照组比较，CMVD组血液FIB(3.31±1.09g/L vs 2.83±0.77g/L)，PLR[742.69(515.82，968.25) vs 642.23(482.28，767.54) ]，HbA1c[6.20%(5.70%，7.50%) vs 5.80% (5.50%，6.50%)]，NLRP3[343.29(217.20，504.90)pg/ml vs 245.02(170.00，328.60)pg/ml] 和LECT-2[23.24(14.92，27.24)ng/ml vs 17.85(10.30，26.41)ng/ml] 表达水平均升高， 差异有统计学意义(t=1.103，Z=-2.172，-2.213，-3.239，-2.592，均P<0.05)。多因素Logistic 回归分析，血液FIB[OR(95%CI)：4.213(1.481 ～ 11.981)]和NLRP3[OR(95%)：1.004(1.000 ～ 1.007)] 是冠心病PCI 术后CMVD 发生的独立危险因素(Waldχ2=7.274，4.061，均P<0.05)。血液FIB 和NLRP3 对冠心病PCI 术后CMVD 发生的预测价值的ROC 曲线下面积分别为0.648 和0.679，二者联合诊断曲线下面积为0.712。结论 冠心病PCI 术后患者血液FIB 和NLRP3 表达水平升高，与CMVD发生密切相关。血液FIB 和NLRP3 可作为冠心病PCI 术后CMVD 发生的预测生物标志物。
Abstract:
Objective To investigate the association of blood fibrinogen (FIB), nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3) and leukocyte cell-derived chemotaxin 2(LECT-2) with the development of coronary microvascular disease (CMVD)in patients after percutaneous coronary intervention (PCI) for coronary artery disease. Methods From July 2021 to September 2022, the patients with symptoms related to myocardial ischemia after PCI for coronary artery disease were collected from the Department of Cardiology of Shaanxi Provincial People’s Hospital, and their coronary angiography or coronary CT angiography suggested epicardial coronary stenosis <50% in diameter. Single electron emission computed tomography (SPECT) was performed to determine coronary flow reserve (CFR). 78 cases were divided into the CMVD group (CFR<2.0) and 47 cases in the control group (CFR ≥ 2.0).Blood FIB, PLR, HbA1c, NLRP3 and LECT-2 levels were measured and their correlation with the occurrence of CMVD after PCI for coronary artery disease was analysed. To evaluate the predictive value of blood FIB, PLR, HbA1c, NLRP3 and LECT-2 on the occurrence of CMVD after coronary artery disease PCI, a receiver operating characteristic (ROC) curve was plotted. Results Compared to the control group, blood FIB (3.31±1.09g/L vs 2.83±0.77g/L), PLR [742.69 (515.82, 968.25) vs 642.23 (482.28, 767.54) ], HbA1c [6.20% (5.70%，7.50%) vs 5.80% (5.50%, 6.50%)], NLRP3 [343.29 (217.20, 504.90) pg/ml vs 245.02 (170.00, 328.60) pg/ml] and LECT-2 [23.24 (14.92, 27.24) ng/ml vs 17.85(10.30, 26.41) ng/ml] expression levels were elevated and the differences were all statistically significant (t=1.103, Z= -2.172, -2.213, -3.239, -2.592, all P<0.05). Multi-factor logistic regression analysis showed that blood FIB [OR(95%CI)：4.213 (1.481 ～ 11.981)] and NLRP3 [OR(95%CI)：1.004(1.000 ～ 1.007)] were independent risk factors for the development of CMVD after PCI for coronary artery disease (Waldχ2=7.274, 4.061, all P< 0.05). The area under the ROC curve for the predictive value of blood FIB and NLRP3 for the development of CMVD after PCI for coronary artery disease were 0.648 and 0.679, respectively, and the area under the combined diagnostic curve was 0.712. Conclusion Elevated blood FIB and NLRP3 expression levels in patients after coronary PCI were closely associated with the development of CMVD. Blood FIB and NLRP3 may be used as predictive biomarkers for the development of CMVD after PCI for coronary artery disease.

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备注/Memo

备注/Memo:
基金项目： 陕西省中医药管理局基金(2021-ZZ-ZY003)：葛兰心宁软胶囊对冠心病PCI 术后合并冠脉微循环障碍患者疗效研究；陕西省人民医院2022 年科技人才支持计划资助项目(2022LJ-04)：急性冠脉综合征PCI 术后合并微循环功能障碍SPECT 定量评估、炎症反应和氧化应激的作用及葛兰心宁的疗效研究。
作者简介：蒋红英（1993-），女，硕士，住院医师，研究方向：心血管疾病，E-mail：2312491072@qq.com。
通讯作者：程功（1975-），男，硕士，主任医师，研究方向：心血管疾病，E-mail：xianchenggong@163.com。
更新日期/Last Update: 2023-11-15