血清胎球蛋白-B和前脂蛋白表达水平对急性心肌梗死患者的诊断价值

目的探讨急性心肌梗死(AMI)和稳定型心绞痛(SA)患者血清中的蛋白表达差异。方法选取2017年8月至2018年1月在宝鸡市中心医院进行冠状动脉造影检查的40例胸痛患者为研究对象。通过蛋白质组学分析鉴定了6种蛋白质,使用PDQuest(n=6)分析来自AMI和SA患者的血清之间蛋白质表达水平的统计学差异。结果在40例患者中,其中27例患者被诊断患有AMI并伴有不稳定斑块,13例患者为SA。AMI组与SA组在年龄分布、性别构成、危险因素(糖尿病、高血压、高胆固醇血症、脑卒中)差异无统计学意义(均P> 0.05)。与SA患者相比,AMI患者血清中纤维蛋白原(γ-A前体)、前脂蛋白、胎球蛋白-B(胎球蛋白样蛋白IRL685)和纤维蛋白原(γ-B链前体)的表达显著增加,差异有统计学意义(t=1.942、3.160、4.243、2.671,P <0.05)。AMI患者的血清角蛋白9表达下降(t=1.561, P <0.05)。用50 ng/mL胎球蛋白-B处理后,分泌肿瘤坏死因子α(TNF-α)的RAW 264.7细胞的比例显著增加,白介素6(IL-6)分泌细胞群也高于未处理对照组。胎球蛋白-B增加了血管平滑肌细胞的半胱天冬酶3、活性基质金属蛋白酶(MMP-2)和基质细胞衍生因子1(SDF-1)的表达。结论 AMI患者血清中胎球蛋白-B和前脂蛋白表达水平高于SA患者。

The diagnostic value of serum fetuin-B and pro-lipoprotein expression levels in patients with acute myocardial infarction

Objective To investigate the differences in serum protein expression between patients with acute myocardial infarction(AMI)and stable angina(SA).Methods 40 patients with chest pain who underwent coronary angiography in Baoji central hospital from August 2017 to January 2018 were selected as research objects.Six proteins were identified by proteomics analysis,and statistical differences in protein expression levels between serum samples from AMI and SA patients were analyzed by PDQuest(n=6).Results Among the 40 subjects,27 patients were diagnosed with AMI with unstable plaque,and 13 were SA.There was no significant difference in age distribution,gender composition and risk factors(diabetes,hypertension,hypercholesterolemia,stroke)between AMI group and SA group(P>0.05).Compared with patients with SA,serum levels of fibrinogen(gamma-a precursor and gamma-B chain precursor),pro-lipoprotein,fetuin-B(fetal-globulin-like protein IRL685)and fibrinogen(gamma-b chain precursor)were significantly increased in AMI patients(t=1.942,3.160,4.243,2.671;P<0.05).In contrast,keratin 9 expression decreased in serum in AMI patients(t=1.561,P<0.05).After treatment with 50 ng/mL fetuin-B,the proportion of RAW264.7 cells which secreted tumor necrosis factorα(TNF-α)was significantly increased,and the cell population which secreted interleukin-6 was also higher than the untreated control group.Fetuin-B increased the expression of caspase 3,active matrix metalloproteinases-2 and stromal-derived factor-1 in vascular smooth muscle cell.Conclusion The expression levels of fetuin-B and pro-lipoprotein in serum of AMI patients are higher than those of SA patients.