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目的探讨单核细胞趋化蛋白-1(MCP-1)在冠心病猝死(SCD)和非SCD病例冠状动脉粥样硬化斑块中表达的差异及其与SCD的关系。方法从本教研室2001至2003年尸检档案中挑选病例及心脏标本共90例。分为SCD组(36例)、对照组Ⅰ(28例,冠心病但不是SCD)和对照组Ⅱ(26例,无明显动脉粥样硬化)。通过免疫组化SABC法及图像分析技术对不同组的MCP-1在斑块内的表达进行阳性细胞面积／扫描面积(R)、平均吸光度值(A)的半定量检测,并分析比较各组表达的差异性。结果SCD组的R值和A值与对照组Ⅰ、对照组Ⅱ相比差异有统计学意义[(0．1264±0．0130比0．0269±0．0110和0．0267±0．0100,P=0．04),(0．4534±0．0830比0．2303±0．0400和0．2158±0．0400,P=0．00)]。而对照组Ⅰ的R值和A值与对照组Ⅱ相比无统计学意义(0．0269±0．0110比0．0267±0．0100,P>0．05),(0．2303±0．0400比0．2158±0．0400,P>0．05)。结论冠状动脉粥样硬化斑块中MCP-1的表达增加与SCD的发生密切相关,为SCD的诊断和临床对冠心病防治的研究提供新的途径。
Objective To investigate the difference of monocyte chemoattractant protein-1 (MCP-1) expression in coronary atherosclerotic plaque in patients with sudden coronary death (SCD) and non-SCD and its relationship with SCD. Methods Totally 90 cases and heart specimens were selected from autopsy files from 2001 to 2003 in this department. The patients were divided into SCD group (36 cases), control group Ⅰ (28 cases, coronary heart disease but not SCD) and control group Ⅱ (26 cases without obvious atherosclerosis). Immunohistochemical SABC method and image analysis technique were used to detect the positive cell area / scan area (R) and average absorbance value (A) of different groups of MCP-1 in plaques. Differences in expression. Results The R value and A value in SCD group were significantly different from those in control group Ⅰ and control group Ⅱ [(0.1264 ± 0.0130 vs 0.0269 ± 0.0110 and 0.0267 ± 0.0100, P = 0.04), (0.4534 ± 0.0830 vs. 0.2303 ± 0.0400 and 0.2158 ± 0.0400, P = 0.00)]. While the value of R and A in control group Ⅰ was not significantly different from that of control group Ⅱ (0.0269 ± 0.0110 vs. 0.0267 ± 0.0100, P> 0.05), (0.2303 ± 0 .0400 vs 0.2158 ± 0.0400, P> 0.05). Conclusion The increased expression of MCP-1 in coronary atherosclerotic plaque is closely related to the occurrence of SCD, which provides a new approach for the diagnosis of SCD and clinical research on the prevention and treatment of coronary heart disease.