中性粒细胞细胞外网络与接触系统在尿毒症急性冠状动脉综合征中的作用

摘要

目的：探讨中性粒细胞细胞外网络(NETs)与接触系统在尿毒症急性冠状动脉综合征(ACS)中的作用。方法选择尿毒症患者44例,分为尿毒症 ACS 组[包括尿毒症 ACS 感染组(A1组)和尿毒症 ACS 非感染组(A2组)两个亚组]、尿毒症非 ACS 组[包括尿毒症非 ACS 感染组(B1组)和尿毒症非 ACS 非感染组(B2组)两个亚组],正常健康查体人群作为健康对照组。采用酶联免疫吸附测定(ELISA)试剂盒,分别检测血清中瓜氨酸化组蛋白 H3(CitH3)和高分子量激肽原(HK)的水平。结果①尿毒症 ACS 组、尿毒症非 ACS 组的血清 CitH3(229.35±131.51)μg/L、(175.40±91.72)μg/L 水平高于健康对照组(120.61±56.18)μg/L；HK(354.55±208.16)ng/L、(429.13±131.62)ng/L 低于健康对照组(562.81±138.80)ng/L,差异有统计学意义(均 P <0.05)。②与 B2组比较,A1组血清 CitH3水平增高(269.31±131.66)μg/L vs (142.65±56.69)μg/L；血清 HK 水平降低(272.84±158.44)ng/L vs (486.44±133.12)ng/L,差异有统计学意义(均 P <0.01)。③A1组中血清 CitH3水平与血小板呈负相关(r =-0.731,P <0.05)。结论 NETs 与接触系统激活在尿毒症患者 ACS 的发病过程中发挥重要作用。%Objective To investigate the mechanism of neutrophil extracellular traps(NETs)and contact system in uremic patients with acute coronary syndrome(ACS).Methods Uremic patients were divided into uremia ACS group (subdivided into uremia ACS infection group [group A1]and uremia ACS non-infection group [group A2])and uremia non-ACS group (subdivided into uremia non-ACS infection group[group B1]and uremia non-ACS non-infection group [group B2 ]),normal healthy patients were chosen as healthy control group.Serum citrullinated histone H3 (CitH3)and high molecular weight kininogen(HK)concentrations were detected with ELISA kits.Results ①Serum CitH3 levels in uremia ACS group (229.35±131.5 1)μg/L and uremia non-ACS group (1 75.40±91.72)μg/L were significantly higher than that of healthy control group (120.61±56.18)μg/L(P <0.05).Serum HK levels in uremia ACS group (354.55±208.1 6)ng/L and uremia non-ACS group (429.13±131.62)ng/L were significantly lower than that of healthy control group (562.81±138.80)ng/L(P <0.05).②Compared with group B2,serum CitH3 level of group A1 was significantly increased (269.31±131.66)μg/L vs (142.65±56.69)μg/L,respectively(P <0.01),and serum HK level of group A1 was significantly decreased (272.84 ± 1 58.44 )ng/L vs (486.44 ± 133.12 )ng/L, respectively(P < 0.01 ).③ Serum CitH3 level of group A1 showed a significant negative correlation with platelet account (r = -0.731,P < 0.05 ).Conclusion NETs and contact system activation played important roles in the mechanism of uremic patients with ACS.