单核细胞LOX-1、CX3CR1表达与冠状动脉近段/中段狭窄的关系

摘要

Objective To investigate the correlation of the expressions of lectin-like oxidized low-density lipoprotein receptor-1(LOX-1) and CX3C chemokine receptor 1(CX3CR1) from monocytes and proximal/middle coronary artery stenosis. Methods A total of 58 patients undergoing coronary angiography were enrolled. According to the results of coronary angiography,47 patients with at least one of main proximal or middle coronary artery stenosis≥50% were as stenosis group,and 11 patients <50% were as non-stenosis group. Totally,26 volunteers were enrolled as control group. General information and parameters of the 3 groups were recorded. LOX-1 and CX3CR1 fluorescence intensities from monocytes in peripheral blood were determined by flow cytometry,and the severity of coronary artery lesion was evaluated by Gensini score. The expression levels of LOX-1 and CX3CR1 of single-branch lesion,double-branch lesion and multiple-branch lesion(3-branch or more) were compared. The correlation of the fluorescence intensities of LOX-1 and CX3CR1 from monocytes and Gensini score was analyzed. Multiple Logistic regression analysis and receiver operating characteristic(ROC) curve analysis were performed. Results The fluorescence intensities of LOX-1 and CX3CR1 from monocytes in peripheral blood in stenosis group were higher than those in non-stenosis group and control group(P<0.01). There was no statistical significance in the fluorescence intensities of LOX-1 and CX3CR1 from monocytes in peripheral blood among single-branch lesion,double-branch lesion and multiple-branch lesion(P>0.05). There was no correlation of the fluorescence intensities of LOX-1 and CX3CR1 from monocytes in peripheral blood with left ventricular ejection fraction(LVEF),left ventricular end diastolic dimension(LVDD) and Gensini score in stenosis group(P>0.05). Multiple Logistic regression analysis and ROC curve analysis showed that CX3CR1 was a factor of proximal/middle coronary artery stenosis with diagnosis efficiency [odds ratio(OR)=1.771, 95% confidence interval(CI) 1.200-2.616]. The area under ROC curve was 0.733. Conclusions LOX-1 and CX3CR1 from monocytes may be involved in the process of proximal/middle coronary artery stenosis,without the correlation with stenosis degree. The high expression of CX3CR1 is a factor of proximal/middle coronary artery stenosis with diagnosis efficiency.%目的 探讨外周血单核细胞血凝素样氧化低密度脂蛋白受体-1(LOX-1)、CX3C趋化因子受体1(CX3CR1)表达与冠状动脉近段/中段狭窄的关系.方法 选取行冠状动脉造影术的患者58例,根据冠状动脉造影结果 分为近段/中段狭窄组(至少1支主要冠状动脉血管近段或中段狭窄≥50%,简称狭窄组;47例)和病变不明显组(冠状动脉血管狭窄<50%,11例).以26名志愿者作为对照组.记录3个组的一般资料及实验室指标,采用流式细胞术测定外周血单核细胞LOX-1、CX3CR1荧光表达强度,以Gensini积分系统来评估冠状动脉病变严重程度,比较单支病变、2支病变及多支(3支及以上)病变患者单核细胞LOX-1、CX3CR1的荧光表达强度.分析单核细胞LOX-1、CX3CR1荧光表达强度与各项指标及Gensini积分之间的相关性,采用多因素逐步Logistic回归分析及受试者工作特征(ROC)曲线评价冠状动脉近段/中段狭窄性疾病的影响因素及其诊断价值.结果 狭窄组外周血单核细胞LOX-1、CX3CR1荧光表达强度明显高于病变不明显组及对照组(P<0.01).狭窄组中单支病变、2支病变、多支病变之间外周血单核细胞LOX-1、CX3CR1荧光表达强度差异均无统计学意义(P>0.05).狭窄组外周血单核细胞LOX-1、CX3CR1荧光表达强度与左心室射血分数(LVEF)、左心室舒张末期内径(LVDD)、Gensini积分均无相关性(P>0.05).多因素逐步Logistic回归分析及ROC曲线分析显示,CX3CR1是冠状动脉近段/中段狭窄的影响因素[比值比(OR)=1.771,95%可信区间(CI)1.200~2.616],且具有一定的诊断效力(ROC曲线下面积为0.733).结论 单核细胞LOX-1、CX3CR1高表达可能参与了冠状动脉近段/中段狭窄的病变过程,但与其狭窄程度无关.单核细胞CX3CR1高表达是冠状动脉近段/中段狭窄的影响因素,且对疾病诊断有一定的效力.