[1]郝翠君a,王 蕊a,洪 洋a,等.急性心肌梗死患者PBMC中CSF2RB mRNA和GZMA mRNA表达水平与PCI术后心室重构的关系研究[J].现代检验医学杂志,2025,40(02):77-82.[doi:10.3969/j.issn.1671-7414.2025.02.014]
　HAO Cuijuna,WANG Ruia,HONG Yanga,et al.Relationship between CSF2RB mRNA and GZMA mRNA Expression Levels in PBMC of Patients with Acute Myocardial Infarction and Ventricular Remodeling after PCI[J].Journal of Modern Laboratory Medicine,2025,40(02):77-82.[doi:10.3969/j.issn.1671-7414.2025.02.014]
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急性心肌梗死患者PBMC中CSF2RB mRNA和GZMA mRNA表达水平与PCI术后心室重构的关系研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第40卷
期数:
2025年02期
页码:
77-82
栏目:
论著
出版日期:
2025-03-15

文章信息/Info

Title:
Relationship between CSF2RB mRNA and GZMA mRNA Expression Levels in PBMC of Patients with Acute Myocardial Infarction and Ventricular Remodeling after PCI
文章编号:
1671-7414（2025）02-077-06
作者:
郝翠君a; 王 蕊a; 洪 洋a; 李晓颖b; 韩少洁a; 李方江a
（河北北方学院附属第一医院 a. 心血管内科；b. 检验科，河北张家口 075000）
Author(s):
HAO Cuijuna;  WANG Ruia;  HONG Yanga;  LI Xiaoyingb;  HAN Shaojiea;  LI Fangjianga
（a. Department of Cardiovascular Medicine; b. Department of Clinical Laboratory, the First Affiliated Hospital of Hebei North University, Hebei Zhangjiakou 075000, China）
关键词:
急性心肌梗死; 经皮冠状动脉介入; 集落刺激因子2 受体β 亚单位; 颗粒酶A; 心室重构
分类号:
R542.22；R392.11
DOI:
10.3969/j.issn.1671-7414.2025.02.014
文献标志码:
A
摘要:
目的 探究急性心肌梗死（AMI）患者外周血单个核细胞（PBMC）中集落刺激因子2 受体β 亚单位（CSF2RB）和颗粒酶A（GZMA）的mRNA表达水平与经皮冠状动脉介入术（PCI）术后心室重构的关系。方法 选取2022 年2 月～ 2023年8 月河北北方学院附属第一医院收治的161 例AMI患者作为研究对象，根据是否心室重构进一步分为非重构组（n=105）与重构组（n=56）；以同期该院收治的未发生心肌梗死的85 例冠心病患者为对照组。收集患者临床资料，实时荧光定量聚合酶链式反应（RT-PCR）法检测PBMC 的CSF2RB mRNA，GZMA mRNA 水平；超声心动图检测心脏结构参数指标，采用Pearson 分析CSF2RB mRNA，GZMA mRNA 水平与心脏结构参数的相关性；经单因素、多因素Logistic 回归分析AMI 患者发生心室重构的影响因素。结果 两组CSF2RB mRNA（1.15±0.28 vs 1.80±0.37），GZMA mRNA（0.85±0.16vs 1.15±0.26）表达及胱抑素 C(CysC)，同型半胱氨酸（Hcy）水平比较，差异具有统计学意义（t=-39.002~ -4.854，均P<0.05）。随访截止2024 年8 月，161 例行PCI 术AMI 患者中56 例发生心室重构；AMI 患者中重构组CSF2RBmRNA（1.85±0.31），GZMA mRNA（1.27±0.29）表达水平明显高于非重构组（1.71±0.34，1.12±0.30），差异具有统计学意义(t=2.564，3.057，均P<0.001)。术后AMI 患者中重构组左心房内径(LAD)、左心室舒张末内径( LVEDD)、左心室后壁舒张末期厚度(LVPWTd)、室间隔厚度(IVST) 均高于非重构组（t=11.247 ～ 26.008），左心室射血分数(LVEF)低于重构组(t=-15.271)，差异具有统计学意义（均P<0.001）。Pearson 相关性分析AMI 患者CSF2RB mRNA，GZMAmRNA水平与LAD，LVEDD，LVPWTd，IVST 呈正相关（rCSF2RB mRNA=0.657 ～ 0.754，rGZMA mRNA=0.512 ～ 0.745，均P＜ 0.05），与LVEF 呈负相关（r=-0.684，-0.754，均P ＜ 0.05）。重构组与非重构组在Cys C 和Hcy 在使用醛固醇受体拮抗剂水平差异具有统计学意义（t=5.495，20.710，30.906，均P ＜ 0.05）。Logistic 回归分析显示，CSF2RB mRNA ＞ 1.79，GZMA mRNA ＞ 1.18，Hcy ＞ 20.15μmol/L，未使用醛固醇受体拮抗剂是AMI 患者发生心室重构的独立危险因素（Waldχ2=1.137 ～ 3.206，均P<0.05）；LVEF ＞ 58.11% 是AMI 患者发生心室重构的独立保护因素(Wald χ2=1.469，P<0.05)。结论 AMI 患者PBMC 中CSF2R BmRNA 和GZMA mRNA 表达水平明显升高，CSF2RB 和GZMA 是AMI 患者术后发生心室重构的独立危险因素，可作为AMI 后发生心室重构的潜在诊断标志。
Abstract:
Objective To investigate the relationship between the mRNA expression levels of colony stimulating factor 2 receptor subunit beta CSF2RB and granase A （GZMA） in peripheral blood mononuclear cells （PBMC） of patients with acute myocardial infarction （AMI） and ventricular remodeling after percutaneous coronary intervention（PCI）. Methods A total of 161 AMI patients admitted to the First Affiliated Hospital of Hebei North University from February 2022 to August 2023 were selected as the study objects, and were further divided into non-remodeling group(n=105) and remodeling group(n=56) according to whether ventricular remodeling was possible. A total of 85 patients with coronary heart disease who did not have myocardial infarction were taken as control group. The clinical data of patients were collected, and the expression levels of CSF2RB and GZMA mRNA in peripheral blood mononuclear cells were detected by real-time fluorescence quantitative PCR. Cardiac structural parameters were detected by echocardiography, and the relationship between CSF2RB and GZMA mRNA levels and cardiac structural parameters was analyzed by Pearson correlation. The influencing factors of ventricular remodeling in AMI patients were analyzed by univariate and Logistic regression, and P<0.05 was considered statistically significant. Results The mRNA expression of CSF2RB(1.15±0.28 vs 1.80±0.37), GZMA(0.85±0.16 vs 1.15±0.26), Cys C and Hcy levels were compared between the two groups, and the differences were statistically significant(t=-39.002~ -4.854, all P< 0.05).The followup was up to August 2024. Among 161 AMI patients who underwent PCI, 56 cases had ventricular remodeling. The expression level of CSF2RB mRNA(1.85±0.31), GZMA mRNA(1.27±0.29) in the reconstructed group were significantly higher than that in the non-reconstructed group (1.71±0.34, 1.12±0.30), and the differences were statistically significant (t=2.564,3.057, all P<0.001). LAD, LVEDD, LVPWTd and IVST in the postoperative reconstruction group were higher than those in the nonreconstruction group(t=11.247~26.008), and LVEF was lower than that in the reconstruction group(t=-15.271), with statistical significance (all P<0.001).The level of CSF2RB and GZMA in AMI patients was positively correlated with LAD, LVEDD, LVPWTd and IVST(rCSF2RB mRNA=0.657~0.754, rGZMA mRNA=0.512~0.745), and negatively correlated with LVEF(r=-0.684, -0.754), with statistical significance (all P < 0.05).There was a statistically significant differences in the levels of Cys C and Hcy between the reconstructed group and non-reconstructed group after the use of aldehyed steroid receptor antagonsts (t=5.495, 20.710, 30.906, all P< 0.05). Logistic regression analysis showed that CSF2RBmRNA ＞ 1.79, GZMAmRNA ＞ 1.18, Hcy ＞ 20.15μmol/L and no use of aldosterol receptorantagonists were independent risk factors for ventricular remodeling in AMI patients. LVEF ＞ 58.11% was an independent protective factor for ventricular remodeling in AMI patients (Wald χ2=1.137~3.206, P<0.05). Conclusion The expression levels of CSF2RB and GZMA in PBMC of AMI patients were significantly increased. CSF2RB and GZMA are independent risk factors for postoperative ventricular remodeling in patients with AMI, and can be used as potential diagnostic markers for ventricular remodeling after acute myocardial infarction.

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备注/Memo

备注/Memo:
基金项目：河北省2020 年度医学科学研究课题计划（20200509）；张家口市2023 年市级科技计划自筹项目（2322147D）。
作者简介：郝翠君（1988-），女，硕士研究生，主治医师，研究方向：心血管病学，E-mail：xinneikehcj@163.com。
通讯作者：王蕊（1984-），女，硕士研究生，副主任医师，研究方向：心血管病学，E-mail：xinneikewr@163.com。
更新日期/Last Update: 2025-03-15