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目的:探讨冠心病患者血清中趋化因子CX3CL1的表达在冠心病中的临床意义。方法:采用病例-对照的研究方法,依据临床症状收集经冠脉造影显示确诊为冠心病的患者250例,其中临床症状诊断为稳定性心绞痛患者75例,不稳定型心绞痛患者75例,急性心肌梗死患者100例(其中包含ST段抬高型急性心肌梗死和非ST段抬高型急性心肌梗死患者各50例)。同期收集对照组200例,对照组为冠状动脉造影显示为正常。ELISA方法检测上述不同人群血清中趋化因子CX3CL1表达变化,利用流式细胞仪检测上述不同人群血清中CD4~+CD28~-CX3CR1+T细胞表达含量的变化。结果:冠心病患者组血清趋化因子CX3CL1表达明显高于对照组(P<0.05);与稳定型冠心病组患者相比较,不稳定型冠心病组和急性心肌梗死组患者血清中趋化因子CX3CL1水平明显高于稳定型冠心病患者组(P<0.05);ST段抬高型急性心肌梗死患者血清CX3CL1表达水平高于非ST段抬高型急性心肌梗死患者(P<0.05)。不稳定型心绞痛患者冠状动脉介入手术后即刻抽取患者的静脉血,血清中CX3CL1表达含量明显高于冠状动脉介入手术前血清中的表达含量。冠心病患者CD4~+CD28~-CX3CR1+T细胞受体的表达含量明显增高,在急性ST段抬高型心肌梗死患者血清中的表达最高(P<0.05)。结论:趋化因子CX3CL1可能参与冠心病动脉粥样硬化不稳定斑块的形成,并且可能成为外周血中预测不稳定型斑块的血清生物学标志物。
Objective: To investigate the clinical significance of serum chemokine CX3CL1 expression in patients with coronary heart disease. Methods: A case-control study was conducted. According to clinical symptoms, 250 patients with coronary heart disease confirmed by coronary angiography were collected. Among them, 75 cases were diagnosed as stable angina pectoris, 75 cases were unstable angina pectoris, 75 cases were acute myocardial infarction 100 patients with infarction (including ST-segment elevation acute myocardial infarction and non-ST-segment elevation acute myocardial infarction in 50 patients). In the same period, 200 cases of the control group were collected, and the control group showed normal coronary angiography. ELISA was used to detect the expression of CX3CL1 in serum of different groups. The expression of CD4 ~ + CD28 ~ -CX3CR1 + T cells in serum was detected by flow cytometry. Results: The expression of chemokine CX3CL1 in patients with coronary heart disease was significantly higher than that in the control group (P <0.05). Compared with patients with stable coronary heart disease, the levels of chemokines in patients with unstable coronary heart disease and acute myocardial infarction The level of CX3CL1 in patients with ST-segment elevation acute myocardial infarction was significantly higher than that in patients with stable coronary heart disease (P <0.05). The level of CX3CL1 in patients with ST-elevation acute myocardial infarction was significantly higher than that in patients without ST-segment elevation acute myocardial infarction (P <0.05). In patients with unstable angina pectoris, venous blood was drawn immediately after coronary intervention. The expression of CX3CL1 in serum was significantly higher than that in the serum before coronary intervention. The expression of CD4 ~ + CD28 ~ -CX3CR1 + T cell receptor in patients with coronary heart disease was significantly higher than that in patients with acute ST-segment elevation myocardial infarction (P <0.05). CONCLUSION: The chemokine CX3CL1 may be involved in the formation of atherosclerotic plaque in coronary heart disease and may be a serum biomarker for predicting unstable plaques in peripheral blood.