【摘要】：背景調(diào)查研究發(fā)現(xiàn),冠狀動脈粥樣硬化性心臟病的患病率逐年上升,且年輕化趨勢愈加明顯。已經(jīng)有越來越多的權(quán)威研究報道證實,人體內(nèi)相關(guān)炎癥反應(yīng)參與了冠脈粥樣硬化病變的始發(fā)過程。還原型煙酰胺腺嘌呤二核苷酸磷酸氧化酶(Nicotinamide adenine dinucleotide phosphate oxidase,NOX)是機(jī)體細(xì)胞內(nèi)富有氧化活性的蛋白質(zhì),其家族中的某些亞型被視為動脈粥樣硬化病變進(jìn)展過程中的重要調(diào)節(jié)因子。NOX在血小板、吞噬細(xì)胞和心血管細(xì)胞中均有表達(dá),NOX參與了心血管系統(tǒng)諸多功能的調(diào)節(jié),例如細(xì)胞分化、增殖等生理過程,同時參與炎癥反應(yīng)和氧化應(yīng)激等病理過程。NOX某些亞型尤其是Nox2與高血壓病、血管側(cè)支形成、動脈粥樣硬化病變等緊密相關(guān)。內(nèi)皮細(xì)胞表達(dá)的Nox2可增加超氧化合物的產(chǎn)生,促進(jìn)吞噬細(xì)胞集聚于動脈血管早期病變處。最新研究證實,Nox2可以增加血小板活性,從而促進(jìn)血小板聚集,最終促進(jìn)血小板依賴的血栓生成。目的通過檢測血小板Nox2蛋白的表達(dá)水平,初步判斷其對冠心病的診斷價值;探討血小板Nox2蛋白與冠脈粥樣硬化病變程度的關(guān)系;進(jìn)而通過檢測血小板Nox2蛋白初步判定冠狀動脈病變程度,為冠心病患者冠脈病變嚴(yán)重程度提供一定的理論依據(jù)。方法按入選標(biāo)準(zhǔn),需符合WHO初治CHD的診斷標(biāo)準(zhǔn),選取選取2015年8月-2016年2月由新鄉(xiāng)醫(yī)學(xué)院一附院心血管內(nèi)科收治的初治CHD且入院后行冠狀動脈介入診療的患者81例,其中男性42女性39例。排除標(biāo)準(zhǔn):住院期間診斷患急、慢性肝腎腎功能不全;全身任何一個或多個系統(tǒng)的惡性腫瘤;患有血液系統(tǒng)疾病患者;口服抗血小板藥物史患者。依照冠脈造影診斷,冠脈正常組22例;冠脈病變組59例,其中輕、中、重度狹窄組分別有13例、18例和28例。入選患者臨床資料,高血壓病和糖尿病病史等。血生化檢測血脂指標(biāo)、血同型半胱氨酸(HCY);補體C3、C4。血小板Nox2蛋白表達(dá)水平采用Western-blot方法檢測。所有入選患者均知情同意并簽署知情同意書。結(jié)果冠狀動脈病變組高血壓病、糖尿病患者的比例及TG、LDL-C、HCY的含量均高于冠狀動脈正常組(P0.05),HDL-C低于冠脈正常組(P0.05)。冠脈病變組血小板Nox2高于正常組(P0.05),冠狀動脈病變組中補體C3和補體C4的水平高于冠狀動脈正常組(P0.05)。冠狀動脈中度、重度病變患者血小板Nox2蛋白的表達(dá)水平升高(P0.01);血小板Nox2蛋白表達(dá)水平與冠脈病變嚴(yán)重程度呈正相關(guān)。血小板Nox2蛋白與補體C3、C4的濃度呈正相關(guān)。結(jié)論1.血小板Nox2蛋白的表達(dá)水平對冠心病的診斷有一定的價值,且與冠脈粥樣硬化病變嚴(yán)重程度呈正相關(guān)。2.血小板Nox2蛋白很可能與補體C3、C4存在協(xié)同作用,共同參與了冠脈粥樣病變的發(fā)生以及發(fā)展過程。
[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.
【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R541.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 阮洪生;牟晉珠;;表兒茶素對脂多糖誘導(dǎo)RAW264.7細(xì)胞分泌炎癥因子的影響[J];中國實驗方劑學(xué)雜志;2017年04期

2 彭軍;;高同型半胱氨酸血癥與高血壓、冠心病相關(guān)性研究[J];中西醫(yī)結(jié)合心腦血管病雜志;2014年11期

3 陳_g;任甜甜;;冠心病患者免疫功能臨床研究[J];國際檢驗醫(yī)學(xué)雜志;2013年14期

4 陳可冀;劉s，

本文編號：2197278