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目的分析核转录因子过氧化物酶增殖体激活受体γ(PPARγ)mRNA表达与冠脉病变的相关性,探讨PPARγ对冠脉病变的作用机制。方法经冠脉造影确诊的冠心病患者(CHD组)153例,其中稳定型心绞痛(SAP组)55例,急性冠脉综合征(ACS组)98例,后者包括不稳定型心绞痛(US组)50例和急性心梗(AMI组)48例,对照组为经冠脉造影排除冠心病者85例。测定外周血有核细胞中PPARγmRNA表达水平并分析其与冠脉病变程度的相关性。结果与对照组比较,CHD组PPARγmRNA、HDL-C明显降低,胰岛素抵抗指数(IRI)、体重指数(BMI)、血浆总胆固醇酯(TC)、低密度脂蛋白胆固醇(LDL-C)明显增加。与SAP组比较,ACS组PPARγmRNA、HDL-C明显降低,而病变支数、IRI明显增加。CHD组PPARγmRNA表达与冠脉病变支数、病变类型呈负相关(r=-0.42,P<0·001;r=-0·56,P<0.001)。结论PPARγ基因是冠脉病变的负调控基因,其通过增加胰岛素敏感性、调节脂质代谢、抑制血管壁炎症反应起到抗动脉粥样硬化作用。
Objective To analyze the correlation between nuclear transcription factor peroxisome proliferator - activated receptor γ (PPARγ) mRNA expression and coronary artery lesion, and to explore the mechanism of PPARγ on coronary artery lesion. Methods A total of 153 CHD patients diagnosed by coronary angiography (CHD group), including 55 patients with stable angina pectoris (SAP) and 98 patients with acute coronary syndrome (ACS), including unstable angina (US group) ) And 50 cases of acute myocardial infarction (AMI group) 48 cases, the control group of coronary artery disease by coronary angiography in 85 cases. The level of PPARγmRNA expression in peripheral blood mononuclear cells was determined and its correlation with the extent of coronary lesions was analyzed. Results Compared with the control group, the levels of PPARγmRNA and HDL-C in CHD group were significantly decreased, while the IRI, BMI, TC and LDL-C were significantly increased. Compared with SAP group, the levels of PPARγmRNA and HDL-C in ACS group decreased significantly, but the number of lesions and IRI increased significantly. The expression of PPARγmRNA in CHD group was negatively correlated with the number of coronary lesions and the type of lesions (r = -0.42, P <0.001; r = -0.56, P <0.001). Conclusion PPARγ gene is a negative regulator of coronary artery disease. It plays a role of anti-atherosclerosis by increasing insulin sensitivity, regulating lipid metabolism and inhibiting the inflammation of blood vessel wall.