摘要
[目的]探讨促红细胞生成素产生肝细胞受体A2(EphA2)、颗粒蛋白前体(PGRN)与冠状动脉疾病(CAD)患者内皮炎症及黏附因子的相关性。[方法]入选2020年1月—12月复旦大学附属中山医院心内科收治的拟行冠状动脉造影的73例CAD患者,入院次日晨空腹采集肘静脉血5 mL,ELISA测定血清中EphA2、PGRN水平,Premixed Luminex测定肿瘤坏死因子α(TNF-α)、白细胞介素2(IL-2)、白细胞介素6(IL-6)、单核细胞趋化蛋白1(MCP-1)、血管细胞黏附分子1(VCAM-1)及γ干扰素(IFN-γ)水平。[结果]急性冠状动脉综合征(ACS)患者血清EphA2、氨基末端脑钠肽前体(NT-proBNP)、心肌肌钙蛋白T(cTnT)、高敏C反应蛋白(hs-CRP)及肌酸激酶同工酶MB(CK-MB)心肌损伤标志物水平较慢性冠状动脉综合征(CCS)患者升高6.3倍、15倍、161倍、13倍、2.5倍(P<0.001),血清TNF-α、IL-6和VCAM-1较CCS患者升高37.9%、500.0%、196.6%(P<0.01),血清PGRN水平较CCS患者未见明显升高(P=0.051)。血清EphA2、PGRN、IL-6、VCAM-1预测ACS的曲线下面积(AUC)分别为0.932、0.646、0.926和0.861。血清EphA2、VCAM-1、IL-6、TNF-α、MCP-1均与Gensini评分正相关(r=0.533,P<0.001;r=0.549,P<0.001;r=0.621,P<0.001;r=0.263,P=0.027;r=0.264,P=0.026)。血清EphA2与IL-6、VCAM-1呈正相关(r=0.565,P<0.001;r=0.474,P<0.001)。未见PGRN与各炎症因子和黏附因子之间的相关性(P>0.05)。血清PGRN、EphA2与心肌损伤标志物呈正相关(P<0.05)。[结论]本研究从临床的角度支持EphA2参与斑块损伤急性期内皮炎症过程,同时提示EphA2、PGRN有望成为干预内皮炎症与预测动脉粥样硬化病变进展的潜在靶点。
Aim To investigate the correlation between erythropoietin-producing hepatocellular receptor A2(EphA2),progranulin(PGRN),and endothelial inflammatory and adhesion factors in patients with coronary artery disease(CAD).Methods From January to December 2020,73 CAD patients who were admitted to the Department of Cardiology of Zhongshan Hospital Affiliated to Fudan University for coronary angiography were selected.5 mL of elbow vein blood was collected on an empty stomach the next morning after admission.Serum EphA2 and PGRN levels were determined by ELISA,and serum tumor necrosis factor-α(TNF-α),interleukin-2(IL-2),interleukin-6(IL-6),monocyte chemoattractant protein-1(MCP-1),vascular cell adhesion molecule-1(VCAM-1)and interferon-γ(IFN-γ)levels were determined by Premixed Luminex.Results The levels of serum EphA2,N-terminal pro-brain natriuretic peptide(NT proBNP),cardiac troponin T(cTnT),high sensitivity C-reactive protein(hs-CRP),creatine kinase isoenzyme-MB(CKMB)myocardial injury markers in patients with acute coronary syndrome(ACS)were 6.3 times,15 times,161 times,13 times,2.5 times higher than those in patients with chronic coronary syndrome(CCS)(P<0.001),and serum TNF-α,IL-6 and VCAM-1 were 37.9%,500.0% and 196.6% higher than those in CCS patients(P<0.01),and serum PGRN levels were not significantly higher than those in CCS patients(P=0.051).The area under curve(AUC)of serum EphA2,PGRN,IL-6,and VCAM-1 in predicting ACS were 0.932,0.646,0.926 and 0.861 respectively.Serum EphA2,VCAM-1,IL-6,TNF-α and MCP-1 was positively correlated with Gensini scores(r=0.533,P<0.001;r=0.549,P<0.001;r=0.621,P<0.001;r=0.263,P=0.027;r=0.264,P=0.026).Serum EphA2 was positively correlated with IL-6 and VCAM-1 respectively(r=0.565,P<0.001;r=0.474,P<0.001).There was no correlation between PGRN and inflammatory factors and adhesion factors(P>0.05).Serum PGRN and EphA2 were positively correlated with myocardial injury markers(P<0.05).Conclusions This study supports that EphA2 is involved in the process of endothelial inflammation in the acute stage of plaque injury from a clinical perspective,and suggests that EphA2 and PGRN may be potential targets to intervene in endothelial inflammation and predict the progression of atherosclerotic lesions.
作者
田丹
李明飞
许青
李晓宇
吕迁洲
TIAN Dan;LI Mingfei;XU Qing;LI Xiaoyu;Lü Qianzhou(Department of Pharmacy,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Cardiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China)
出处
《中国动脉硬化杂志》
CAS
2023年第1期49-55,87,共8页
Chinese Journal of Arteriosclerosis
基金
上海市临床重点专科(临床药学)建设项目(shslczdzk06504)。
