双链DNA与急性ST段抬高型心肌梗死的相关性分析

Correlation between Double-Stranded DNA and Acute ST Segment Elevation Myocardial Infarction

目的探讨急性ST段抬高型心肌梗死(STEMI)的发生与双链DNA (dsDNA)含量的相关性。方法随机入选发病12 h内入住西安交通大学第一附属医院心内科重症监护室行急诊冠状动脉支架植入术的STEMI患者145例,抽取外周动脉血、梗死相关冠状动脉血,另抽取3例正常人外周动脉血作为对照。应用免疫荧光染色及免疫酶标法检测中性粒细胞外诱捕网(NETs)骨架结构及dsDNA含量,并同时检测心肌酶、肌钙蛋白、白细胞等提示心肌梗死的相关指标。分析dsDNA与心肌梗死相关指标的相关性。结果 STEMI患者梗死相关冠状动脉血中dsDNA含量和NETs骨架结构明显高于STEMI患者外周动脉血,差异有统计学意义(P=0.037,P=0.027);dsDNA含量与肌酸激酶、肌酸激酶同工酶、肌钙蛋白T及白细胞水平呈正相关(r=0.185,P=0.030;r=0.168,P=0.049;r=0.337, P=0.003;r=0.181,P=0.033)。结论 dsDNA可能与STEMI的发生相关。

Objective To examine the correlation between double-stranded DNA(dsDNA) and acute ST segment elevation myocardial infarction(STEMI). Methods Blood from the peripheral and infarct-related coronary arteries was collected from 145 patients with STEMI during primary percutaneous revascularization. Immunofluorescence was performed to analyze the structure of neutrophil extracellular traps(NETs),dsDNA,and their correlation with creatine kinase(CK),creatine kinase-MB(CK-MB),troponin(cTn),and leukocytes. Results dsDNA and NETs structures were accumulated in infarct-related coronary arteries of patients with STEMI;significant differences were observed when compared with peripheral arteries from the same patients(P = 0.037,P = 0.027 1). There were positive relationships between dsDNA and CK,CK-MB,c Tn,and leukocytes(r = 0.185,P = 0.03;r = 0.168,P = 0.049;r = 0.337,P < 0.01;r = 0.181,P = 0.033,respectively). Conclusion dsDNA and NETs structures may be related to STEMI.