【摘要】 目的分析急性冠状动脉综合征(ACS)患者外周血单个核细胞(PBMCs)节律基因表达水平的变化及其与冠状动脉病变严重程度的相关性。方法选择2011年9月—2012年2月疑诊为冠状动脉性心脏病并行冠状动脉造影检查的85例住院患者,按临床症状、心电图、心肌酶谱及冠状动脉造影检查结果分为稳定型心绞痛(SAP)组(40例)和ACS组(45例),所有患者留取全血,经Ficoll离心分离PBMCs,体外培养过程中经血清撤离诱导节律性;采用定量聚合酶链反应检测相关节律基因的表达情况,再经Chronos-fit软件评估其节律性。采用Gensini积分评价冠状动脉病变严重程度。结果与SAP组比较,ACS组的PBMCs节律性表现为峰值时间改变且整体表达水平降低。Gensini积分与PBMCs节律基因Per1的峰值时间呈正相关(r=0.855,P<0.01),与其表达水平呈负相关(r=-0.753,P<0.05),与节律基因Rev-erbα的相关性则相反(r值分别为-0.721和0.832,P值均<0.05)。结论 ACS患者PBMCs的节律性明显异常,且与冠状动脉病变的严重程度密切相关,这可能是患者整体节律性紊乱的表现,其将可能应用于临床患者冠状动脉病变的早期预测。更多还原

【Abstract】 Objective To explore the expression of circadian clock genes in peripheral blood mononuclear cells(PBMCs) and the association with the severity of coronary artery lesions in patients with acute coronary syndrome(ACS).Methods From September 2011 to February 2012,85 hospitalized patients with suspected diagnosis of coronary heart diseases were enrolled in this study.They were divided into stable angina pectoris(SAP,40 patients) group and ACS group(45 patients) according to clinical symptoms and the results of electrocardiogram,cardiac muscle zymogram and coronary arteriography.PBMCs were isolated from the blood by Ficoll density gradient centrifugation.The rhythm was induced in vitro by serum deprivation.The expression of circadian clock genes was detected by quantitative polymerase chain reaction(qPCR) and the circadian rhythm were assessed with Chronos-fit program.The severity of lesions was evaluated by Gensini scores.Results Compared with SAP group,the expression of circadian clock genes in ACS group was abnormal,which was manifested as changed peak time and decreased transcript levels.Gensini scores were positively correlated with the peak time of Per1 in PBMCs(r=0.855,P<0.01) and negatively correlated with the expression level of the gene(r=-0.753,P<0.05),which were opposite in another circadian gene Rev-erbα(r=-0.721,r=0.832,all P<0.05).Conclusion The expression of circadian clock genes in PBMCs is abnormal in ACS patients,and is associated with the severity of coronary artery lesions.It may reflect the disorder of circadian rhythm of the whole body and can be used for early prediction of coronary artery diseases in clinic.更多还原