[1]王兰 叶玉兰 宁明安 张迪 尚粉青.血清PCSK9水平与PCI后冠状动脉病变再进展的关系研究[J].心血管病学进展,2022,(7):667-672.[doi:10.16806/j.cnki.issn.1004-3934.2022.07.000]
　WANG Lan,YE Yulan,NING Mingan,et al.Correlation Analysis Between Serum PCSK9 Level and Coronary Artery Pathological ?Progression After PCI[J].Advances in Cardiovascular Diseases,2022,(7):667-672.[doi:10.16806/j.cnki.issn.1004-3934.2022.07.000]
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血清PCSK9水平与PCI后冠状动脉病变再进展的关系研究()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2022年7期
页码:
667-672
栏目:
论著
出版日期:
2022-07-25

文章信息/Info

Title:
Correlation Analysis Between Serum PCSK9 Level and Coronary Artery Pathological ?Progression After PCI
文章编号:
202110106
作者:
王兰1 叶玉兰2 宁明安1 张迪1 尚粉青3
(1.西安市第一医院心内科,陕西 西安 710002;2.西安市高新医院心内科,陕西 西安 710075;3.西安市胸科医院转化医学中心,陕西 西安 710100)
Author(s):
WANG Lan1; YE Yulan2; NING Mingan1; ZHANG Di1; SHANG Fenqing3
(1.Department of Cardiology,The First Hospital of Xian,Xian 710002,Shaanxi,China; 2.Department of Cardiology,Xian Gaoxin Hospital,Xian 710075,Shaanxi,China; 3.Translational Medicine Center,Xian Chest Hospital,Xian 710100,Shaanxi,China)
关键词:
前蛋白转化酶枯草溶菌素9; 经皮冠状动脉介入治疗; 炎症因子
Keywords:
Proprotein convertase subtilisin/kexin type 9; Percutaneous coronary intervention; Inflammatory factor
DOI:
10.16806/j.cnki.issn.1004-3934.2022.07.000
摘要:
目的 探讨冠状动脉支架植入术后病变再进展与血清前蛋白转化酶枯草溶菌素9（PCSK9）水平的相关性。方法 收集2016年1月—2021年1月西安市第一医院和西安市高新医院收治的冠心病患者并行经皮冠状动脉介入治疗，于术后3～5年因胸痛行冠状动脉造影的患者为研究对象。根据造影结果将患者分为对照组（36例）和观察组（38例），比较两组基线资料，测定两组患者血清中的PCSK9水平，分析经皮冠状动脉介入治疗后冠状动脉病变再进展与PCSK9的相关性。测定患者血清中白介素-6（IL-6）、肿瘤坏死因子-ɑ（TNF-ɑ）及单核细胞趋化蛋白-1（MCP-1）的水平，并分析其与PCSK9的相关性。人主动脉平滑肌细胞（SMC）给予PCSK9刺激，观察SMC表型变化及氧化低密度脂蛋白受体-1（LOX-1）的表达。结果 对照组与观察组的血清PCSK9水平分别为（15.02±6.65）ng/mL和（26.94±11.41）ng/mL（P＜0.01），IL-6水平分别为（10.43±2.14）pg/mL和（13.71±2.29）pg/mL（P＜0.01），TNF-ɑ水平分别为（40.94±5.83）pg/mL和（46.06±6.32）pg/mL（P＜0.01），MCP-1水平分别为（67.98±8.78）pg/mL和（79.86±6.94）pg/mL（P＜0.01）。Pearson相关性分析显示，血清PCSK9水平与IL-6、TNF-ɑ及MCP-1呈正相关（r＝0.448 1、0.465 1和0.512 5，均P＜0.01）。PCSK9作用于SMC，导致SMC表型由收缩型向分泌型转换，LOX-1表达显著增加。结论 冠状动脉支架植入术后冠状动脉病变再进展患者血清PCSK9及炎症因子水平高于对照组，血清PCSK9水平与冠状动脉支架植入术后冠状动脉病变再进展有关，这可能主要与PCSK9促进LOX-1表达增加和导致SMC表型转换有关。
Abstract:
Objective To investigate the correlation between serum proprotein convertase subtilisin/kexin type 9(PCSK9) level and coronary artery pathological?progression after percutaneous coronary intervention(PCI). Methods The coronary heart disease p atients with PCI who underwent coronary angiography because of chest pain between three to five years after PCI were included from January 2016 to January 2021 at Xi ’an First Hospital and Xi ’an Gaoxin Hospital. Patients were divided into the control group(36 cases) and the observation group(38 cases) according to the angiographics. The baseline data of the two groups were compared,the serum level of PCSK9 in the two groups was dete cted,and the correlation between the pathological progression of coronary artery after PCI and PCSK9 was analyzed. The levels of interleukin-6(IL-6),tumor necrosis factor-ɑ(TNF-ɑ) and monocyte chemoattractant protein-1(MCP-1) were detected,and their correlation with PCSK9 was analyzed. Human aortic smooth muscle cell(SMC) were stimulated with PCSK9 to observe the phenotypic changes of SMC and the expression of oxidized low density lipoprotein receptor-1(LOX-1). Results The serum PCSK9 level of the control group and the observation group were (15.02±6.65) ng/mL and (26.94±11.41) ng/mL respectively(P<0.01),the IL-6 level of the two group were (10.43±2.14) pg/mL and (13.71±2.29) pg/mL respectively(P<0.01),the TNF-ɑ level of the two group were (40.94±5.83) pg/mL and (46.06±6.32) pg/mL respectively(P<0.01),and the MCP-1 level of the two group were (67.98±8.78) pg/mL and (79.86±6.94) pg/mL respectively(P<0.01). Pearson correlation analysis showed that the serum PCSK9 level was positively correlated with IL-6,TNF-ɑ and MCP-1(r＝0.448 1,r＝0.465 1 and r＝0.512 5,all P<0.01). PCSK9 acted on SMC,resulting in the transformation of SMC phenotype from contractile to secretory,and the expression of LOX-1 increased significantly. Conclusion The level of serum PCSK9 and inflammatory factors in patients with coronary artery pathological progression after PCI were higher than those in the control group ,and the level of serum PCSK9 was associated with coronary artery pathological progression after PCI. This may be mainly related to PCSK9 promoting the expression of LOX-1 and leading to the phenotypic transformation of SMC

参考文献/References:

[1]de Borst GJ,Moll FL. Regarding "patterns of in-stent restenosis after carotid artery stenting:classification and implications for long term outcome"[J]. J Vasc Surg,2008,47(6):1379-1380.

[2]刘千军,田佳文,曲新凯. 老年冠心病患者支架内再狭窄危险因素分析[J]. 老年医学与保健,2021,27(1):76-80.

[3]崔少香. PCI术后支架内再狭窄与血清TGF-β1、ET-1水平及自我管理能力的相关性分析[J].黑龙江医药,2021,34(3):651-653.

[4]Li S,Guo YL,Xu RX,et al. Association of plasma PCSK9 levels with white blood cell count and its subsets in patients with stable coronary artery disease[J]. Atherosclerosis,2014,234(2):441-445.

[5]Zhang Y,Zhu CG,Xu RX,et al. Relation of circulating PCSK9 concentration to fibrinogen in patients with stable coronary artery disease[J]. J Clin Lipidol,2014,8(5):494-500.

[6]Li S,Zhang Y,Xu RX,et al. Proprotein convertase subtilisin-kexin type 9 as a biomarker for the severity of coronary artery disease[J]. Ann Med,2015,47(5):386-393.

[7]Cominacini L,Pasini AF,Garbin U,et al. Oxidized low density lipoprotein (ox-LDL) binding to ox-LDL receptor-1 in endothelial cells induces the activation of NF-kappaB through an increased production of intracellular reactive oxygen species[J]. J Biol Chem,2000,275(17):12633-12638.

[8]Tang Z,Jiang L,Peng J,et al. PCSK9 siRNA suppresses the inflammatory response induced by oxLDL through inhibition of NF-κB activation in THP-1-derived macrophages[J]. Int J Mol Med,2012,30(4):931-938.

[9]Giunzioni I,Tavori H,Covarrubias R,et al. Local effects of human PCSK9 on the atherosclerotic lesion[J]. J Pathol,2016,238(1):52-62.

[10]Ding Z,Wang X,Schnackenberg L,et al. Regulation of autophagy and apoptosis in response to ox-LDL in vascular smooth muscle cells,and the modulatory effects of the microRNA hsa-let-7g[J]. Int J Cardiol,2013,168(2):1378-1385.

[11]Libby P. Inflammation in atherosclerosis[J]. Arterioscler Thromb Vasc Biol,2012,32(9):2045-2051.

[12]Vengrenyuk Y,Nishi H,Long X,et al. Cholesterol loading reprograms the

microRNA-143/145-myocardin axis to convert aortic smooth muscle cells to a dysfunctional macrophage-like phenotype[J]. Arterioscler Thromb Vasc Biol,2015,35(3):535-546.

[13]Kozinski M,Krzewina-Kowalska A,Kubica J,et al. Percutaneous coronary intervention triggers a systemic inflammatory response in patients treated for in-stent restenosis—Comparision with stable and unstable angina[J]. Inflamm Res,2005,54(5):187-193.

[14]Bernelot Moens SJ,Neele AE,Kroon J,et al. PCSK9 monoclonal antibodies reverse the pro-inflammatory profile of monocytes in familial hypercholesterolaemia[J]. Eur Heart J,2017,38(20):1584-1593.

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更新日期/Last Update: 2022-08-22