CC类趋化因子配体5与冠状动脉粥样硬化的相关性研究

Relationship between the Level of CCL5 in Serum and the Severity of Coronary Atherosclerosis

目的:探讨CC类趋化因子配体5(CC chemokine ligand-5,CCL5)的表达水平与冠状动脉粥样硬化(Atherosclerosis,AS)严重程度之间的相关性。方法:将颈动脉粥样硬化狭窄(>70%)行颈动脉内膜切除术的5例手术标本作为AS组,尸检无动脉粥样硬化的正常颈动脉3例作为对照组。应用免疫组织化学、Western blot检测AS组和对照组中CCL5的表达。收集110例冠状动脉造影术患者,根据Gensini评分分为对照组(Gensini评分=0分,n=27),轻微病变组(0<Gensini评分≤20,n=32)和严重病变组(Gensini评分>20,n=51)。收集各组的临床基线资料(包括年龄、性别、血压、血脂、血糖等),ELISA方法检测各组血浆中CCL5表达水平,并分析各危险因素、CCL5表达水平与Gensini评分之间的相关性。结果:颈AS组AS组织中CCL5蛋白的表达明显高于正常颈动脉组(P<0.05),冠心病患者血浆CCL5水平明显高于对照组,差异具有统计学意义(P<0.05)。对照组、轻微病变组和严重病变组在性别、吸烟史、收缩压、舒张压、血糖及血浆CCL5的表达上存在显著的差别。相关性分析显示舒张压、血糖及血浆CCL5表达水平与Gensini评分间呈显著正相关(r=0.276、0.418、0.519,P<0.05)。以Gensini评分为因变量,性别、年龄、吸烟史、收缩压、舒张压、LDL-C、HDL-C、血糖、血浆CCL5为自变量建立多元逐步线性回归模型,结果提示血浆CCL5为Gensini评分的独立预测因子(B值为8.775;P值为0.000)。结论:血浆CCL5水平与冠状动脉粥样硬化病变程度呈正相关,可能作为AS程度的独立预测因子。

Objective： To investigate the relationship between serum CC chemokine ligand 5 （CCL5） level and the severity of coronary atherosclerosis. Methods： The expression of CCL5 protein in carotid atherosclerotic plaques obtained from carotid eversion endarterectomy （CEE） of 5 cases of patients with highgrade stenosis （〉70 %） （AS group） and 3 cases of normal postmortem arteries （control group） were detected by Immunohistochemistry and Western blotting. The CCL5 expression was compared between the two groups. 110 cases of consecutive patients who underwent coronary angiography were selected and divided into the control group （Gensini＇s score = 0, n=27）, mild lesions group （0〈Gensini＇s scores 20, n=32） and severe lesions group （Gensini＇ score〉20, n=51）. The blood pressure, blood lipid, blood glucose and serum CCL5 of all groups were investigated. Their serum CCL5 levels were measured by enzyme linked immunosorbent assay （ELISA）. The relationship between risk factors, serum CCL5 level and Gensini score were analyzed. Results： The expression of CCL5 protein in the carotid artery atherosclerosis was evidently higher than that in the normal carotid artery, and the serum CCL5 level of CAD patients was significantly higher than that of the control group. Sex, smoking history, systolic pressure, diastolic pressure, glucose and serum CCL5 were significantly different among three groups. Correlation analysis indicated that diastolic pressure, glucose and serum CCL5 were positively correlated with Gensini＇s score （r=0.276, 0.418, 0.519; P〈0.05）. In multi-variant linear regression model, serum CCL5 （B=8.775; P=0.000） were established as independent predictors of Gensini＇s score. Conclusions： Serum CCL5 was positively correlated with the severity of coronary artery atherosclerosis and was proved to be an independent predictor of Gensini＇s score.