不稳定型心绞痛患者心外膜脂肪组织厚度及IL-1β表达水平与冠状动脉易损斑块形成相关性分析

Correlation analysis of epicardial adipose tissue thickness and interleukin-1βwith coronary vulnerable plaque in patients with unstable angina

目的通过观察不稳定型心绞痛患者心外膜脂肪组织(EAT)厚度及EAT中白细胞介素1β(IL-1β)表达水平,探讨其与冠状动脉易损斑块(VP)的相关性。方法选择63例不稳定型心绞痛患者,根据血管内超声检测的斑块性质进一步将不稳定型心绞痛患者分为VP组24例、非VP组39例,另选排除冠状动脉粥样硬化性心脏病需接受换瓣手术的心脏瓣膜病患者45例作为对照组。采用超声心动图测量EAT厚度;收集受试者空腹肘静脉血,ELISA法检测血浆IL-1β;免疫组织化学染色及RT-PCR分别检测EAT中IL-1β蛋白及mRNA表达。结果EAT厚度VP组>非VP组>对照组(P均<0.05),三组血浆IL-1β表达差异无统计学意义(P>0.05)。免疫组化染色显示,EAT中IL-1β蛋白在VP组表达最多;EAT中IL-1β mRNA表达VP组>非VP组、对照组(P<0.05)。Spearman相关性分析显示,VP组、非VP组EAT厚度及、EAT中IL-1β水平均与冠状动脉VP呈正相关(r分别为0.34、0.67)。多因素Logistic回归分析显示,EAT厚度、EAT中IL-1β水平是不稳定型心绞痛患者发生VP的独立影响因素。受试者工作曲线分析显示,EAT厚度预测冠状动脉VP的曲线下面积为0.74(95%CI为0.64~0.84);当EAT厚度截断值为4.4mm时,预测冠状动脉VP的敏感度和特异度分别为95.8%和45.2%。结论不稳定型心绞痛患者EAT厚度及EAT中IL-1β水平与冠状动脉VP呈正相关,是冠状动脉VP的独立影响因素。

Objective To observe the expression levels of epicardial adipose tissue(EAT)thickness and interleukin-1β(IL-1β)in ETA of patients with unstable angina and to analysis their correlations with coronary vulnerable plaque(VP).Methods Sixty-three patients with unstable angina were enrolled,including 24 patients with VP(VP group)and 39 patients without VP(NVP group)according to intravascular ultrasound imaging.In addition,45 patients requiring valve replacement surgery but without coronary artery disease(CAD)were enrolled as the control group.Transthoracic echocardiography was used to measure EAT thickness.Plasma IL-1β from fasting elbow vein blood was detected by ELISA.IL-1β protein and mRNA expression levels in EAT were tested by immunostaining and RT-PCR,respectively.Results EAT thickness was in the following order VP group>NVP group>control group(P<0.05).No significant difference in the plasma IL-1β level was found among the three groups(P>0.05).Immunostaining showed that IL-1β expression increased in EAT of patients with VP.The mRNA level of IL-1βin EAT was higher in the VP group than those of the NVP group and the control group(all P<0.05).Spearman correlation analysis showed that both EAT thickness and IL-1β were positively correlated with coronary VP(r=0.34 and 0.67,respectively).Multivariate Logistic regression analysis showed that IL-1β and EAT thickness were the independent risk factors of VP.Receiver operating characteristic curve analysis showed that the area under the curve of EAT thickness in predicting VP was 0.74(95%CI:0.64-0.84).When the cut-off value of EAT thickness was 4.4mm,the sensitivity and specificity in predicting VP were 95.8% and 45.2%,respectively.Conclusion Both EAT thickness and IL-1β are positively correlated with coronary VP,which are independent risk factors of VP.