冠心病患者血浆Jagged1蛋白与冠状动脉侧支循环形成的关系

Relationship Between Plasma Jagged1 Protein Level and Coronary Collateral Circulation in Patients With Coronary Artery Disease

目的:探讨冠心病患者血浆中Jagged1蛋白水平与冠状动脉侧支循环(CCC)形成的关系。方法:根据冠状动脉造影结果入选我院左前降支、左回旋支或右冠状动脉中至少有一支血管直径狭窄≥95%的冠心病患者89例(冠心病组)和造影结果无明显异常的患者30例(正常对照组)。根据Rentrop分级评分将冠心病组患者再分成侧支循环良好亚组(Rentrop分级≥2级,n=42)与侧支循环不良亚组(Rentrop分级≤1级,n=47)。采用酶联免疫吸附法检测所有入选患者血浆中Jagged1蛋白及血管内皮生长因子(VEGF)的浓度,并进行相关性分析。结果:与正常对照组相比,冠心病组患者血浆Jagged1蛋白[(38.74±10.60)ng/L vs(23.04±8.97)ng/L]及VEGF[(113.98±30.80)pg/L vs(72.73±14.55)pg/L]水平均明显升高(P均<0.01)。侧支循环良好亚组与侧支循环不良亚组比血浆Jagged1蛋白[(46.77±8.49)ng/L vs(31.56±6.26)ng/L]及VEGF[(128.10±20.24)pg/L vs(92.43±21.09)pg/L]水平均显著升高(P均<0.01)。冠心病患者血浆Jagged1蛋白与VEGF水平呈正相关(r=0.730,P<0.01)。多元回归分析显示,Jagged1蛋白(OR=1.318,P=0.000)和VEGF(OR=1.043,P=0.043)是影响CCC形成的独立预测因素。结论:侧支循环良好亚组血浆Jagged1蛋白水平较侧支循环不良亚组明显升高,表明Jagged1蛋白在CCC形成过程中可能起重要作用,这为冠心病患者临床治疗提供新的研究方向。

Objective： To explore the relationship between plasma Jagged1 protein level and coronary collateral circulation（CCC） formation in patients with coronary artery disease（CAD）.Methods： According to coronary angiography（CAG） examination, our research was categorized in 2 groups： CAD group, n=89 patients with at least one of left anterior descending（LAD）, left circumflex（LCX） or right coronary artery（RCA） stenosis ≥ 95% and Control group, n=30 subjects without abnormal findings by CAG. Based on Rentrop grading system, CAD group was further divided into 2 subgroups： Good CCC subgroup, n=42 patients with Rentrop grade ≥ 2 and Poor CCC subgroup, n=47 patients with Rentrop grade ≤ 1. Plasma levels of Jagged1 protein,vascular endothelial growth factor（VEGF） were measured by ELISA and the relevant correlation study was conducted by multivariate regression analysis.Results： Compared with Control group, CAD group had increased plasma levels of Jagged1 protein（38.74±10.60）ng/L vs（23.04±8.97）ng/L and elevated VEGF（113.98±30.80）pg/L vs（72.73±14.55）pg/L. Compared with Poor CCC subgroup, Good CCC subgroup presented increased Jagged1 protein（46.77±8.49）ng/L vs（31.56±6.26）ng/L and elevated VEGF（128.10±20.24）pg/L vs（92.43±21.09）pg/L. Correlation study showed that Jagged1 protein was positively related to VEGF in CAD patients（r=0.730, P〈0.01）; multivariate regression analysis indicated that Jagged1 protein（OR=1.318, P=0.000） and VEGF（OR=1.043, P=0.043） were the independent predictors for CCC processing.Conclusion： CAD patients with good CCC had the higher plasma Jagged1 protein level than the patients with poor CCC which implied that Jagged1 protein played important role in CCC processing, such finding may provide a new direction for treating CAD patients in clinical practice.