单核细胞LOX-1、CX3CR1表达与冠状动脉近段/中段狭窄的关系

Correlation of the expressions of LOX-1 and CX3CR1 from monocytes and proximal/middle coronary artery stenosis

目的探讨外周血单核细胞血凝素样氧化低密度脂蛋白受体-1(LOX-1)、CX3C趋化因子受体1(CX3CR1)表达与冠状动脉近段/中段狭窄的关系。方法选取行冠状动脉造影术的患者58例,根据冠状动脉造影结果分为近段/中段狭窄组(至少1支主要冠状动脉血管近段或中段狭窄≥50%,简称狭窄组;47例)和病变不明显组(冠状动脉血管狭窄<50%,11例)。以26名志愿者作为对照组。记录3个组的一般资料及实验室指标,采用流式细胞术测定外周血单核细胞LOX-1、CX3CR1荧光表达强度,以Gensini积分系统来评估冠状动脉病变严重程度,比较单支病变、2支病变及多支(3支及以上)病变患者单核细胞LOX-1、CX3CR1的荧光表达强度。分析单核细胞LOX-1、CX3CR1荧光表达强度与各项指标及Gensini积分之间的相关性,采用多因素逐步Logistic回归分析及受试者工作特征(ROC)曲线评价冠状动脉近段/中段狭窄性疾病的影响因素及其诊断价值。结果狭窄组外周血单核细胞LOX-1、CX3CR1荧光表达强度明显高于病变不明显组及对照组(P<0.01)。狭窄组中单支病变、2支病变、多支病变之间外周血单核细胞LOX-1、CX3CR1荧光表达强度差异均无统计学意义(P>0.05)。狭窄组外周血单核细胞LOX-1、CX3CR1荧光表达强度与左心室射血分数(LVEF)、左心室舒张末期内径(LVDD)、Gensini积分均无相关性(P>0.05)。多因素逐步Logistic回归分析及ROC曲线分析显示,CX3CR1是冠状动脉近段/中段狭窄的影响因素[比值比(OR)=1.771,95%可信区间(CI)1.200~2.616],且具有一定的诊断效力(ROC曲线下面积为0.733)。结论单核细胞LOX-1、CX3CR1高表达可能参与了冠状动脉近段/中段狭窄的病变过程,但与其狭窄程度无关。单核细胞CX3CR1高表达是冠状动脉近段/中段狭窄的影响因素,且对疾病诊断有一定的效力。

Objective To investigate the correlation of the expressions of lectin-like oxidized low-density lipoprotein receptor-1（LOX-1） and CX3C chemokine receptor 1（CX3CR1） from monocytes and proximal/middle coronary artery stenosis. Methods A total of 58 patients undergoing coronary angiography were enrolled. According to the results of coronary angiography,47 patients with at least one of main proximal or middle coronary artery stenosis ≥50% were as stenosis group,and 11 patients 〈50% were as non-stenosis group. Totally,26 volunteers were enrolled as control group. General information and parameters of the 3 groups were recorded. LOX-1 and CX3CR1 uorescence intensities from monocytes in peripheral blood were determined by ow cytometry,and the severity of coronary artery lesion was evaluated by Gensini score. The expression levels of LOX-1 and CX3CR1 of single-branch lesion,double-branch lesion and multiple-branch lesion（3-branch or more） were compared. The correlation of the fluorescence intensities of LOX-1 and CX3CR1 from monocytes and Gensini score was analyzed. Multiple Logistic regression analysis and receiver operating characteristic（ROC） curve analysis were performed. Results The fluorescence intensities of LOX-1 and CX3CR1 from monocytes in peripheral blood in stenosis group were higher than those in non-stenosis group and control group（P〈0.01）. There was no statistical signicance in the uorescence intensities of LOX-1 and CX3CR1 from monocytes in peripheral blood among single-branch lesion,double-branch lesion and multiple-branch lesion（P〉0.05）. There was no correlation of the uorescence intensities of LOX-1 and CX3CR1 from monocytes in peripheral blood with left ventricular ejection fraction（LVEF）,left ventricular end diastolic dimension（LVDD） and Gensini score in stenosis group（P〉0.05）. Multiple Logistic regression analysis and ROC curve analysis showed that CX3CR1 was a factor of proximal/middle coronary artery stenosis with diagnosis efciency [odds ratio（OR）=1.771,95% condence interval（CI） 1.200-2.616]. The area under ROC curve was 0.733. Conclusions LOX-1 and CX3CR1 from monocytes may be involved in the process of proximal/middle coronary artery stenosis,without the correlation with stenosis degree. The high expression of CX3CR1 is a factor of proximal/middle coronary artery stenosis with diagnosis efciency.