摘要
目的 探究1-磷酸鞘氨醇(sphingosine 1-phosphate,S1P)、1-磷酸鞘氨醇受体2(sphingosine 1-phosphate receptor 2,S1PR2)在急性主动脉夹层(acute aortic dissection,AAD)患者外周血单个核细胞(peripheral blood mononuclear cell,PBMC)中的表达及其与患者预后的关系。方法 选取2015年1月至2018年1月青海省心脑血管病专科医院诊治的85例AAD患者为AAD组,并选取同期本院85名体检健康者为对照组。采用实时定量聚合酶链反应(quantitative real time polymerase chain reaction,qRT-PCR)法检测所有受试者PBMC中S1P、S1PR2、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)表达。Pearson法分析AAD患者PBMC中S1P、S1PR2表达与MMP-9的相关性。比较两组不同预后AAD患者临床资料及PBMC中S1P、S1PR2、MMP-9表达。Logistic回归分析对AAD患者预后的影响因素进行分析。采用受试者工作特征曲线(receiver operating characteristic curve,ROC)评价PBMC中S1P、S1PR2、MMP-9表达对AAD患者预后的预测价值。结果 AAD组患者PBMC中S1P表达明显低于对照组,S1PR2、MMP-9表达明显高于对照组,差异有统计学意义(P<0.05)。AAD患者PBMC中S1P表达与MMP-9呈负相关(P<0.05),S1PR2表达与MMP-9呈正相关(P<0.05)。死亡组AAD患者冠状动脉粥样硬化性心脏病(冠心病)比例、S1PR2表达、MMP-9表达均显著高于存活组,S1P表达明显低于存活组,差异具有统计学意义(P<0.05)。S1PR2、MMP-9为AAD预后的危险因素(P<0.05),S1P为AAD预后的保护因素(P<0.05)。PBMC S1P、S1PR2表达预测AAD不良预后的曲线下面积(AUC)分别为0.866、0.875,截断值分别为0.54、1.97,此时对应灵敏度分别为80.0%、76.5%,特异度分别为81.2%、88.2%;两者联合预测AAD不良预后的曲线下面积为0.927,其灵敏度、特异度分别为90.6%、83.5%。结论 AAD患者PBMC中S1P表达下调,S1PR2表达上调,两者可能与MMP-9相互作用,从而共同影响AAD发展,检测S1P、S1PR2表达有助于判断AAD患者的预后情况。
Objectives To investigate the concentrations of sphingosine 1-phosphate(S1P)and sphingosine 1-phosphate receptor 2(S1PR2)in peripheral blood mononuclear cells(PBMC)of patients with acute aortic dissection(AAD)and their relationship with prognosis. Methods A total of 85 cases of AAD patients diagnosed and treated in Qinghai Province Cardiovascular and Cerebrovascular Diseases Specialist Hospital from January 2015 to January 2018 were selected as AAD group,and 85 healthy people in our hospital during the same period were selected as control group.The concentrations of S1P,S1PR2 and matrix metalloproteinase-9(MMP-9)in PBMC were detected by quantitative real time polymerase chain reaction(q RT-PCR). Pearson method was used to analyze the correlation between the concentrations of S1P,S1PR2 and MMP-9 in PBMC of AAD patients. The clinical data of AAD patients with different prognosis and the concentrations of S1P,S1PR2 and MMP-9 in PBMC were compared between the two groups. Logistic regression analysis was used to analyze the prognostic factors of AAD patients. In addition,receiver operating characteristic curve(ROC)was used to evaluate the prognostic value on concentrations of S1P,S1PR2 and MMP-9 in PBMC for patients with AAD. Results The concentration of S1P in PBMC of AAD group was significantly lower than that of control group(P<0.05),and the concentrations of S1PR2 and MMP-9 were significantly higher in AAD group than those of control group(P<0.05). The concentration of S1P in PBMC of AAD patients negatively correlated with MMP-9(P<0.05),while the concentration of S1PR2 positively correlated with MMP-9(P<0.05). The proportion of coronary heart disease,the concentrations of S1PR2 and MMP-9 in death group were significantly higher than those in survival group(P<0.05),and the concentration of S1P was significantly lower than that in survival group(P<0.05). S1PR2 and MMP-9 were the risk factors for the prognosis of AAD(P<0.05),and S1P was a protective factor for the prognosis of AAD(P<0.05). The area under the curve(AU
作者
王期峰
路霖
WANG Qi-feng;LU Lin(Department of Cardiac Surgery,Qinghai Province Cardiovascular and Cerebrovascular Diseases Specialist Hospital,Xining 810000,China)
出处
《岭南心血管病杂志》
CAS
2022年第6期497-501,512,共6页
South China Journal of Cardiovascular Diseases
