急性脑梗死患者外周血单核细胞自噬相关蛋白表达特点

Characteristics of Autophagy-related Protein Expression in Peripheral Blood Monocytes of Patients with Acute Cerebral Infarction

目的探讨急性脑梗死患者外周血单核细胞自噬相关蛋白表达特点及其与线粒体功能变化的相关性。方法随机纳入我院2020年1月至2021年5月80例急性脑梗死患者,依照发病时间将患者分为<4.5h组、4.5~6h组和>6h组3组;使用改良Rankin量表评估预后,纳入同期40例健康人为对照组,比较不同组患者单核细胞自噬相关蛋白表达的差异及与患者线粒体功能指标CF6水平的相关性。结果<4.5h组、4.5~6h组和>6h组MAP1-LC3、Beclin 1、Atg5-Atg12等单核细胞自噬相关蛋白水平呈明显升高趋势,在>6h组中最高,上述指标亦随着NIHSS评分的升高而升高,在溶栓治疗后单核细胞自噬相关蛋白表达明显下降,在预后不良组上述指标明显高于预后良好组(P<0.05),MAP1-LC3、Beclin 1、Atg5-Atg12均与线粒体功能指标变化存在相关性(P<0.05)。结论急性脑梗死患者单核细胞自噬相关蛋白表达显著升高,随着发病时间延长和病变严重程度的加重,其表达水平进一步升高,自噬可能介导急性脑梗死的发病、病情进展和预后不良。

Objective To investigate the expression characteristics of autophagy related proteins in peripheral blood monocytes of patients with acute cerebral infarction and its correlation with mitochondrial function.Methods 80 patients with acute cerebral infarction in our hospital from January 2020 to May 2021 were randomly enrolled and divided into<4.5h group,4.5-6h group and>6h group according to onset time.The improved Rankin scale was used to evaluate the prognosis,and 40 healthy subjects were included in the control group during the same period.The expression of monocyte autophagy related proteins in different groups and its correlation with the level of mitochondrial function indicator CF6 were compared.Results The levels of MAP1-LC3,Beclin 1,Atg5-Atg12 and other monocyte autophagy related proteins in<4.5h,4.5-6h and>6h groups were significantly increased,and were the highest in>6h group.The above indexes also increased with the increase of NIHSS score.After thrombolytic therapy,the expression of autophagy-related proteins in monocytes decreased significantly,and the above indexes in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05).MAP1-lc3,Beclin 1,Atg5-Atg12 were correlated with the changes of mitochondrial function indexes(P<0.05).Conclusion The expression of autophagy-related proteins in monocytes in patients with acute cerebral infarction is significantly increased,and the expression level is further increased with the prolongation of onset time and the aggravation of disease severity.Autophagy may mediate the onset,progression and poor prognosis of acute cerebral infarction.