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目的:探讨CC类趋化因子配体5(CC chemokine ligand-5,CCL5)的表达水平与冠状动脉粥样硬化(Atherosclerosis,AS)严重程度之间的相关性。方法:将颈动脉粥样硬化狭窄(>70%)行颈动脉内膜切除术的5例手术标本作为AS组,尸检无动脉粥样硬化的正常颈动脉3例作为对照组。应用免疫组织化学、Western blot检测AS组和对照组中CCL5的表达。收集110例冠状动脉造影术患者,根据Gensini评分分为对照组(Gensini评分=0分,n=27),轻微病变组(020,n=51)。收集各组的临床基线资料(包括年龄、性别、血压、血脂、血糖等),ELISA方法检测各组血浆中CCL5表达水平,并分析各危险因素、CCL5表达水平与Gensini评分之间的相关性。结果:颈AS组AS组织中CCL5蛋白的表达明显高于正常颈动脉组(P<0.05),冠心病患者血浆CCL5水平明显高于对照组,差异具有统计学意义(P<0.05)。对照组、轻微病变组和严重病变组在性别、吸烟史、收缩压、舒张压、血糖及血浆CCL5的表达上存在显著的差别。相关性分析显示舒张压、血糖及血浆CCL5表达水平与Gensini评分间呈显著正相关(r=0.276、0.418、0.519,P<0.05)。以Gensini评分为因变量,性别、年龄、吸烟史、收缩压、舒张压、LDL-C、HDL-C、血糖、血浆CCL5为自变量建立多元逐步线性回归模型,结果提示血浆CCL5为Gensini评分的独立预测因子(B值为8.775;P值为0.000)。结论:血浆CCL5水平与冠状动脉粥样硬化病变程度呈正相关,可能作为AS程度的独立预测因子。
Objective: To investigate the correlation between the expression of CC chemokine ligand-5 (CCL5) and the severity of coronary atherosclerosis (AS). Methods: Five cases of carotid endarterectomy with carotid atherosclerosis stenosis (> 70%) were selected as AS group and 3 cases of normal carotid arteries without autolysarkemia as control group. Immunohistochemistry and Western blot were used to detect the expression of CCL5 in AS and control groups. 110 patients underwent coronary angiography were divided into control group (Gensini score = 0, n = 27), mild lesion group (0 20, n = 51). The clinical baseline data (including age, sex, blood pressure, blood lipids, blood glucose, etc.) of each group were collected. The expression of CCL5 in each group was detected by ELISA, and the correlation between the risk factors and CCL5 expression and Gensini score was analyzed. Results: The expression of CCL5 protein in AS group was significantly higher than that in normal carotid artery group (P <0.05). The plasma CCL5 level in CHD group was significantly higher than that in control group (P <0.05). There were significant differences in sex, smoking history, systolic blood pressure, diastolic blood pressure, blood glucose and plasma CCL5 expression between the control group, the mild group and the severe group. Correlation analysis showed that there was a significant positive correlation between diastolic blood pressure, blood glucose and plasma CCL5 expression and Gensini score (r = 0.276, 0.418, 0.519, P <0.05). Gensini score as the dependent variable, gender, age, smoking history, systolic blood pressure, diastolic blood pressure, LDL-C, HDL-C, blood glucose and plasma CCL5 as independent variables to establish a multivariate stepwise linear regression model results suggest that plasma CCL5 Gensini score Independent predictors (B value 8.775; P value 0.000). Conclusion: Plasma CCL5 level is positively correlated with the degree of coronary atherosclerosis and may be used as an independent predictor of AS level.