摘要
目的探讨急性ST段抬高型心肌梗死(STEMI)患者哺乳动物雷帕霉素靶蛋白1(mTORC1)在冠状动脉内血栓中的表达。方法选取2019年12月至2020年6月在杭州师范大学附属医院行急诊经皮冠状动脉介入(PCI)联合血栓抽吸的44例STEMI患者为观察组,同院同期就诊且冠状动脉造影检查正常的44例患者为对照组。观察组血栓标本通过血栓抽吸术后获得,对照组血栓标本通过采集动脉血进行体外制备获得。采用免疫组化法检测血栓中mTORC1、NLRP3、蛋白激酶C(PKC)、S6激酶(S6K)。计算表达区占比并作组间比较。结果观察组血栓中mTORC1、NLRP3、PKC、S6K表达区域占比均明显高于对照组(均P<0.05),其中观察组患者血栓中mTORC1表达区域与CD68表达区域重合。观察组患者mTORC1表达区占比与年龄、缺血时间、超敏C反应蛋白水平均呈正相关(均P<0.05),与血脂、血糖及尿酸无相关性(均P>0.05)。以mTORC1表达区占比25%为分界点,将观察组44例患者分为mTORC1高表达组22例、低表达组22例,两组患者累计生存率比较,差异无统计学意义(P>0.05)。结论STEMI患者冠状动脉内血栓中mTORC1表达增加。
Objective To evaluate the expression of mammalian target of rapamycin complex 1(mTORC1)in coronary thrombus in patients with ST-segment elevation myocardial infarction(STEMI).Methods Forty-four STEMI patients underwent primary PCI with thrombus aspiration were enrolled from December 2019 to June 2020 in the Affiliated Hospital of Hangzhou Normal University and thrombus was aspirated from culprit vessels(observation group).Meanwhile,44 patients with normal coronary angiography were selected as control group and blood samples were obtained from peripheral artery for thrombus analysis.The expression of mTORC1,NLRP3,PKC and S6K in thrombus were detected using immunohistochemical staining.The percentage of expression area was calculated and compared between the two groups.Results The percentage of the expression area of mTORC1,NLRP3,PKC and S6K in thrombus was significantly higher in observation group than in control group(P<0.05).The expression areas of mTORC1 and CD68 were overlaps.The percentage of expression area of mTORC1 in the observation group was positively correlated with age,ischemia time and hs-CRP level(P<0.05),and not related with blood lipid,blood glucose and uric acid.According to the cut-off point of 25%of mTORC1 expression area,22 cases had low expression and another 22 cases had high expression in observation group,and there was no significant difference in cumulative survival rate between low and high expression cases.Conclusion The expression of mTORC1 is increased in coronary thrombus of STEMI patients.
作者
蔡梦阳
张媛媛
张邢炜
CAI Mengyang;ZHANG Yuanyuan;ZHANG Xingwei(College of Medical,Hangzhou Normal University,Hangzhou 310036,China)
出处
《心电与循环》
2020年第6期532-536,I0005,共6页
Journal of Electrocardiology and Circulation
基金
浙江省自然科学基金(LQ18H020006)
浙江省科技厅计划项目(2020KY216)
杭州市卫生科技计划项目(OO20190126)。
关键词
ST段抬高型心肌梗死
血栓
哺乳动物雷帕霉素靶蛋白
ST-segment elevation myocardial infarction
Thrombus
Mammalian target of rapamycin complex 1
