血红蛋白清道夫受体与冠状动脉斑块形态关系的临床研究

Relationship between Haemoglobin Scavenger Recaptor CD163 Expression and the Morphology of Atherosclerotic Plaque in Coronary Artery

目的:探讨冠心病患者血红蛋白清道夫受体(CD163)与冠状动脉斑块形态及稳定性的关系。方法:76例冠心病患者分为急性心肌梗死(AMI)组20例,不稳定型心绞痛(UAP)组26例,稳定型心绞痛(SAP)组30例,均经冠状动脉造影(CAG)确诊,20例CAG结果正常者为对照组(N组)。采用流式细胞仪测定各组患者全血单核细胞表面CD163表达水平及超敏C反应蛋白(hs-CRP)水平,分析CD163与冠状动脉斑块形态和稳定性的关系。结果:CD163在AMI组、UAP组、SAP组和对照组中的表达分别为(91.18±7.29)mfi、(67.18±6.12)mfi、(39.26±5.37)mfi和(22.78±4.67)mfi;各组间有显著差异(P<0.01);AMI组CD163的表达水平显著高于UAP组、SAP组和N组(P<0.001)。UAP组CD163的表达水平显著高于SAP组和N组(P<0.001)。SAP组CD163的表达水平显著高于N组(P<0.001)。各组CD163与hs-CRP水平呈正相关(r=0.657,P<0.01)。AMI组、UAP组Ⅱ型斑块的发生率显著高于SAP组,Ⅰ型、Ⅲ型斑块发生率显著低于SAP组(P<0.01)。Ⅱ型斑块易破裂。CD163及hs-CRP水平在Ⅱ型斑块组显著高于Ⅰ型、Ⅲ型斑块组(P<0.01)。结论:随着冠心病病情加重,CD163的表达水平逐渐升高,它可反映体内动脉粥样硬化相关的炎症程度,Ⅱ型斑块患者CD163表达显著增高,可作为预测斑块稳定性的标志物。

Objective：To investigate the relationship between haemoglobin scavenger recaptor CD163 expression and the morphology of atherosclerotic plaque in coronary artery.Methods： A total of 76 patients with coronary heart disease（CHD） were divided into the acute myocardial infarction（AMI） group（n=20）,the unstable angina pectoris（UAP） group（n=26） and the stable angina pectoris（SAP） group（n=30）,by coronary angiography（CAG）,20 normal subjects without CHD diagnosed by CAG served as the control group.Expression levels of CD163 on monocytes were detected by means of flow cytometry,and the results were showns as mean fluorescence intensity（mfi）.The relationships between CD163 and the morphology of atherosclerotic plaque in coronary artery were analyzed.Serum hs-CRP were also measured.Results： In AMI,UAP,SAP and the control group,the mean level of CD163 was（91.18±7.29） mfi,（67.18±6.12） mfi,（39.26±5.37） mfi and（22.78±4.67） mfi,the mean level of CD163 was obviously higher in the AMI and UAP group than in the SAP and control group（P0.01）.The level of CD163 was positive correlated with hs-CRP.TypeⅡ plaque was obviously higher in the AMI and UAP group than in the SAP group（P0.01）.Type Ⅱ plaque may prone to rupture.The level of CD163 in typeⅡ was obviously higher than in the ⅠandⅢplaque group.Conclusions： Aggravates along with coronary disease condition,the hemoglobin scavenger recaptor CD163′s expression level elevates gradually,may reflect in vivo atherosclerosis related inflammation degree,in typeⅡ plaque group patient hemoglobin scavenger recaptor CD163′s expression obvious markup,may probably act as one of the biomarkers of vulnerable plaques.