血红蛋白清道夫受体在急性冠脉综合征中的意义

Significance of CD163 in acute coronary syndrome

目的探讨外周血单核细胞表面血红蛋白清道夫受体(CD163)的表达水平在急性冠脉综合征(ACS)中的意义,结合冠状动脉造影,分析CD163表达水平与冠脉病变程度的关系。并探讨CD163与炎症和脂质过氧化反应的关系。方法按WHO冠心病诊断标准,选择该科84例冠心病(CHD)患者和20例非冠心病(NCHD)作为研究对象。84例CHD分为3组:急性心肌梗死(AMI)30例,不稳定心绞痛(UA)30例,稳定性心绞痛(SA)24例。4组患者均在入院当天采用流式细胞仪检测全血单核细胞表面CD163表达水平,以平均荧光强度mfi为单位。4组患者均行冠状动脉造影并按照Jenkins评分系统进行评分。同时测定C反应蛋白(CRP)和低密度脂蛋白胆固醇(LDL-C),并与CD163进行相关性分析。结果4组患者外周血单核细胞表面CD163的表达水平有明显差异(P<0.001)。其中AMI组CD163的表达水平(85.38±6.89)mfi明显高于UA组[(65.18±5.52)mfi,P<0.001]、SA组[(45.26±4.73)mfi,P<0.001]和NCHD组[(20.95±3.42)mfi,P<0.001]。UA组CD163的表达水平明显高于SA组和NCHD组(P<0.001)。SA组CD163的表达水平明显高于NCHD组(P<0.001)。CHD患者外周血单核细胞表面CD163的表达水平与冠状动脉造影的Jenkins评分具有明显的正相关关系(r=0.9107,P<0.001)。CHD患者外周血单核细胞表面CD163的表达水平亦与CRP呈正相关(r=0.766,P<0.001),与LDL-C呈正相关关系(r=0.749,P<0.001)。结论不同类型冠心病患者的外周血单核细胞表面CD163的表达水平不同,ACS患者的CD163的表达水平明显高于UA和NCHD组。随着冠心病病情加重,CD163的表达水平逐渐升高,可作为指示冠心病临床类型、评估冠心病危险性的有用指标。外周血单核细胞表面CD163的表达水平越高,冠状动脉狭窄病变越严重。CD163与炎症和脂质过氧化反应有关。

[Objective] To evaluate the significance of hemoglobin scavenger receptor （CD163） on the surface of monocytes in peripheral blood in patients with acute coronary syndrome （ACS）, relationship between the expression level of CD163 and the stenosis degree of the coronary artery by the coronary angiography （GAG）, and relationship between the expression level of CD163 and inflammation and lipid peroxidation response. [Methods] According to WHO diagnostic criterior of coronary heart disease （CHD） and the results of GAG, 84 cases of CHD and 20 cases of non-CHD （NCHD） were included in this study. 84 cases of CHD were divided into three groups： 30 cases in acute myocardial infarction （AMI） group, 30 cases in unstable angina （UA）, 24 cases in stable angina （SA）, The expression levels of CD163 on monocytes in peripheral blood in four groups were detected by the flow cytometry and the results were expressed with mean fluorescence intensity （mfi）. CAC were all conducted in four cases and the results were further evaluated by Jenkins score. The concentration of CRP and LDL-C were detected and were compared with CD163. [Results] The expression levels of CD163 on monocytes in peripheral blood in four groups are significantly different （P 〈0.001）. The level of CD163 in AMI group [（85.38±6.89） mfi] is higher than those of the UA group [（65.18±5.52） mfi, P 〈0.001], the SA group [（45.26±4.73）mfi, P 〈0.001] and the NCHD group [（20.95±3.42） raft, P 〈0.001]. The level ofCD163 in the UA group is higher than those of the SA group and the NCHD group （P 〈0.001）. The level of CD163 in the SA group is higher than that of the NCHD group （P 〈0.001）. The expression levels of CD163 on monocytes in peripheral blood in CHD is significantly and positively correlated with Jenkins score （r=0.9107, P〈0.001）, CRP （r=0.766, P 〈0.001） and LDL-C （r =0.749, P 〈0.001）. [Conclusions] The expression levels of CD163 on mono- eytes in peripheral blood in the patients with various types of CHD are signitieantly different, The level of CD163 in the patients with ACS is higher than those of the UA and NCHD groups. The more serious CHD is, the more active inflammatory and lipid peroxidation responses there are in the body, and so the expression levels of CD163 get higher. The expression levels of CD163 on monoeytes in peripheral blood in CHD is significantly and positively correlated with the coronary atherosclerofic severity. The expression levels of CDt63 is novel independent predictor of coronary atherosclerotic severity. The expression levels of CD163 on monocytes is positively correlated with inflammation and lipid peroxidation response.