急诊心肌梗死患者KV1.3-CaN-NFAT信号通路表达及预后观察

Expression of KV1.3-CaN-NFAT signal pathway and prognosis in patients with acute myocardial infarction

目的研究急诊心肌梗死患者电压门控性钾离子通道1.3(KV1.3)-钙调神经磷酸酶(CaN)-活化T细胞核因子(NFAT)信号通路表达及预后。方法选取如皋市人民医院2019年4月—2021年4月急诊入院的148例心肌梗死患者纳入研究对象,随访1年根据预后情况分为预后良好(n=121)和预后不良(n=27)两组。记录并比较两组患者性别、年龄、体质量指数(BMI)、既往病史(高血压、糖尿病、冠心病、高脂血症等)、吸烟史、饮酒史、住院时间、收缩压(SBP)、舒张压(DBP)、左心室射血分数(LVEF),采集外周空腹静脉血,密度梯度离心获得淋巴细胞,Western blotting检测KV1.3、CaN、NFAT的相对蛋白表达。通过ROC分析KV1.3、CaN、NFAT预测急诊心肌梗死患者预后不良的价值;急诊心肌梗死患者预后不良的危险因素采取多因素Logistic回归性分析明确。结果两组患者的性别、BMI、高血压史、糖尿病史、冠心病史、高脂血症史、吸烟史、饮酒史、住院时间、SBP、DBP比较差异无统计学意义(P>0.05),预后不良组年龄≥60岁、LVEF<50%占比及KV1.3、CaN、NFAT显著高于预后良好组(P<0.05);经ROC和Logistic分析,年龄≥60岁、LVEF<50%、KV1.3≥1.370、CaN≥1.378、NFAT≥1.260是急诊心肌梗死患者预后不良的危险因素(P<0.05)。结论KV1.3、CaN、NFAT会影响急诊心肌梗死患者的预后情况,急诊心肌梗死患者预后不良时KV1.3、CaN、NFAT表达会升高。

Objective To study the expression of voltage-gated potassium channel 1.3(KV1.3)-calcineurin(CaN)-activated T cell nuclear factor(NFAT)signaling pathway in patients with emergency myocardial infarction and its correlation with of the patients.Methods 148 patients with emergency myocardial infarction were hospitalized and were divided into two groups:good prognosis group(n=121)and poor prognosis(n=27)after follow-up of 1 years.Relavant clinical data,such as gender,age,body mass index(Body Mass Index,BMI),medical history of hypertension,diabetes,coronary heart disease,hyperlipidemia,etc.,smoking history,history of drinking,length of hospital stay,systolic blood pressure(SBP),diastolic blood pressure(DBP),left ventricular ejection fraction(LVEF)were recorded.Peripheral fasting venous blood samples were collected,lymphocytes were obtained by density gradient centrifugation,and Western blotting was used to test the relative protein expression of KV1.3,CaN,and NFAT.Multivariate Logistic regression was used to identify the risk factors for poor prognosis of ther patients with AMI.ROC was used to analyze the predictive values of KV1.3,CaN,and NFAT in predicting the poor prognosis of AMI patients.Results There was no significant differences in gender,BMI,history of hypertension,diabetes,coronary heart disease,hyperlipidemia etc.,history of smoking,history of drinking,length of hospital stay,SBP,and DBP between these two groups(all P>0.05).Age≥60 years,LVEF<50%,KV1.3,CaN,and NFAT in the poor prognosis group were all significantly higher than those in the good prognosis group(all P<0.05).According to ROC and Logistic analysis,age≥60 years,LVEF<50%,KV1.3≥1.370,CaN≥1.378,andf NFAT≥1.260 were risk factors for poor prognosis in patients with emergency myocardial infarction(all P<0.05).Conclusion The expression levels of KV1.3,CaN,and NFAT will increase the risk of poor prognosis of patients with emergency myocardial infarction.