急性心肌梗死患者血清低密度脂蛋白受体相关蛋白6水平及临床意义

Serum low-density lipoprotein receptor-related protein 6 level and its clinical significance in patients with acute myocardial infarction

目的探讨急性心肌梗死(AMI)患者血清低密度脂蛋白受体相关蛋白6(LRP6)水平变化在AMI中的临床意义。方法选择浙江省衢州市人民医院2017年1月至2018年12月住院的急性AMI患者150例作为AMI组,疑诊冠心病无冠状动脉狭窄者150例为对照组。Western blot测定血清LRP6水平。酶联免疫吸附试验(ELISA)测定血清B型脑钠肽(BNP)、心肌肌钙蛋白I(cTnI)水平。结果AMI组总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)高于对照组[(4.42±0.79)mmol/L比(3.79±0.82)mmol/L、(1.52±0.33)mmol/L比(1.37±0.38)mmol/L、(3.15±0.34)mmol/L比(2.91±0.28)mmol/L],高密度脂蛋白胆固醇(HDL-D)低于对照组[(0.95±0.26)mmol/L比(1.21±0.33)mmol/L],差异均有统计学意义(P<0.05)。AMI组血清LRP6和左室射血分数低于对照组[0.12±0.03比0.38±0.07、(53.27±6.89)%比(66.82±7.35)%],BNP和cTnI水平高于对照组[(78.16±5.27)ng/L比(7.13±1.24)ng/L、(125.83±3.26)ng/L比(0.71±0.24)ng/L],差异均有统计学意义(P<0.05)。AMI患者血清LRP6水平与LDL-C、BNP、cTnI、SYNTAX积分呈负相关(r=-0.587、-0.523、-0.542、-0.583,P<0.05),与左室射血分数呈正相关(r=0.515,P<0.05)。结论AMI患者血清LRP6水平降低,血清LRP6与AMI严重程度和冠状动脉病变程度关系密切。

Objective To investigate the clinical significance of serum low-density lipoprotein receptor-related protein 6(LRP6)level in patients with acute myocardial infarction(AMI).Methods One hundred and fifty patients with AMI were selected as the AMI group and 150 patients with suspected coronary heart disease without coronary artery stenosis were selected as control group from January 2017 to December 2018 in Quzhou People′s Hospital of Zhejiang.The serum LRP6 levels were determined by Western blot.The serum B-type brain natriuretic peptide(BNP)and cardiac troponin I(cTnI)levels were determined by enzyme-linked immunosorbent assay(ELISA).Results The levels of total cholesterol(TC),triglyceride(TG)and low-density lipoprotein cholesterol(LDL-C)in AMI group were higher than those in the control group[(4.42±0.79)mmol/L vs.(3.79±0.82)mmol/L,(1.52±0.33)mmol/L vs.(1.37±0.38)mmol/L,(3.15±0.34)mmol/L vs.(2.91±0.28)mmol/L],and the level of high-density lipoprotein cholesterol(HDL-C)was lower than that in control group[(0.95±0.26)mmol/L vs.(1.21±0.33)mmol/L],and there were significant differences(P<0.05).The level of serum LRP6 and left ventricular ejection fractionin in AMI group were lower than those in control group[0.12±0.03 vs.0.38±0.07,(53.27±6.89)%vs.(66.82±7.35)%],and the BNP and cTnI levels were higher than those in control group[(78.16±5.27)ng/L vs.(7.13±1.24)ng/L,(125.83±3.26)ng/L vs.(0.71±0.24)ng/L],and there were significant differences(P<0.05).The serum LRP6 level was negatively correlated with LDL-C,BNP,cTnI and SYNTAX scores(r=-0.587,-0.523,-0.542,-0.583,P<0.05),and was positively correlated with left ventricular ejection fraction(r=0.515,P<0.05).Conclusions Serum LRP6 level is decreased in patients with AMI.Serum LRP6 is closely related to the severity of AMI and the extent of coronary artery disease.