心脏病合并糖尿病患者围术期自噬微管相关蛋白轻链3抗体Ⅱ水平变化及其与炎性因子水平、心肌缺血再灌注损伤的相关性研究

Change of Autophagy Microtubule Associated Protein Light Chain 3 Antibody Ⅱ in Perioperative Heart Disease Patients Merged with Diabetes and Its Correlations with Inflammatory Cytokines and Myocardial Ischemia Reperfusion Injury

背景细胞自噬在心肌缺血再灌注损伤及2型糖尿病发生发展过程中发挥着重要作用,因此明确心脏病合并糖尿病患者围术期细胞自噬作用具有重要意义。目的分析心脏病合并糖尿病患者围术期自噬微管相关蛋白轻链3抗体Ⅱ(LC3Ⅱ)水平变化及其与炎性因子水平、心肌缺血再灌注损伤的相关性。方法选取2016—2017年武汉大学人民医院心胸外科收治的心脏病合并糖尿病患者64例作为观察组,同期未合并糖尿病的心脏病患者64例作为对照组。两组患者均根据冠状动脉、瓣膜及血管病变情况选择相应手术方法,比较两组患者手术前后LC3Ⅱ及炎性因子〔包括白介素6(IL-6)及白介素8(IL-8)〕水平,术后24 h乳酸脱氢酶(LDH)、心肌肌钙蛋白T(cTnT)及肌酸激酶同工酶(CK-MB)水平;LC3Ⅱ水平与围术期心脏病合并糖尿病患者IL-6、IL-8、LDH、cTnT、CK-MB水平的相关性分析采用Pearson相关分析。结果 (1)两组患者术前LC3Ⅱ、IL-6、IL-8水平比较,差异无统计学意义(P>0.05);术后观察组患者LC3Ⅱ、IL-6、IL-8水平高于对照组(P<0.05)。(2)术后24 h观察组患者LDH、cTnT、CK-MB水平高于对照组(P<0.05)。(3)Pearson相关分析结果显示,LC3Ⅱ水平与围术期心脏病合并糖尿病患者IL-6(r=0.955)、IL-8(r=0.962)、LDH(r=0.981)、cTnT(r=0.964)、CK-MB(r=0.969)水平呈正相关(P<0.01)。结论心脏病合并糖尿病患者围术期LC3Ⅱ水平较高,且LC3Ⅱ水平与炎性因子水平及心肌缺血再灌注损伤有关。

Background Autophagy plays an important role in the occurrence and development of myocardial ischemia reperfusion injury and type 2 diabetes mellitus,thus make sense of the action of autophagy is of great significance in perioperative heart disease patients merged with diabetes.Objective To analyze the change of autophagy microtubule associated protein light chain 3 antibodyⅡ(LC3Ⅱ)in perioperative heart disease patients merged with diabetes and its correlations with inflammatory cytokines and myocardial ischemia reperfusion injury.Methods From 2016 to 2017,a total of 64 heart disease patients merged with diabetes were selected as observation group in the Department of Cardiothoracic Surgery,Renmin Hospital of Wuhan University,meanwhile a total of 64 heart disease patients merged with non diabetes were selected as control group.Patients in the two groups received corresponding operation according the lesions of coronary artery,valves and vessels.LC3Ⅱand inflammatory cytokines(including IL-6 and IL-8)before and after operation,LDH,cTnT and CK-MB 24 hours after operation were compared between the two groups;Pearson correlation analysis was used to analyze the correlations of LC3Ⅱwith IL-6,IL-8,LDH,cTnT and CK-MB in perioperative heart disease patients merged with diabetes.Results(1)No statistically significant difference of LC3Ⅱ,IL-6 or IL-8 was found between the two groups before operation(P>0.05),while LC3Ⅱ,IL-6 and IL-8 in observation group were statistically significantly higher than those in control group after operation(P<0.05).(2)LDH,cTnT and CK-MB in observation group were statistically significantly higher than those in control group 24 hours after operation(P<0.05).(3)Pearson correlation analysis results showed that,LC3Ⅱwas positively correlated with IL-8(r=0.962),IL-6(r=0.955),LDH(r=0.981),cTnT(r=0.964)and CK-MB(r=0.969)in perioperative heart disease patients merged with diabetes(P<0.01).Conclusion LC3Ⅱis significantly elevated in perioperative heart disease patients merged with diabetes,moreover it is significantly correlated with inflammatory cytokines and myocardial ischemia reperfusion injury.