冠心病患者冠状动脉侧支循环的形成与PDGF mRNA水平的关系

目的:探讨冠心病患者单核细胞血小板源性生长因子(PDGF)与冠状动脉侧支循环的关系。方法:依据选择性冠状动脉造影结果将64例患者分为对照组(非冠心病患者,n=15)、冠心病不伴侧支循环组(n=31)、冠心病伴侧支循环组(n=18),采用RT-PCR技术检测3组患者主动脉根部血液及股动脉血液中单核细胞PDGFmRNA水平。结果:(1)冠心病患者有、无侧支循环组之间的冠状脉动病变程度、不稳定心绞痛及心肌梗死发生率无显著差异(P>0.05);但无侧支循环患者心功能不全、室壁瘤的发生率显著增加(P<0.01);(2)与对照组相比,冠心病患者主动脉根部血液单核细胞PDGFmRNA水平增加(P<0.01);有侧支循环患者增加更为显著(P<0.01);而冠心病患者股动脉血液中单核细胞PDGFmRNA水平显著增加(P<0.01),有无侧支循环者之间无显著差别(P>0.05)。结论:冠状动脉侧支循环的建立可显著降低心肌梗死后心功能不全、室壁瘤的发生;PDGFmRNA水平增加与冠状动脉侧支循环形成密切相关;侧支循环形成与否可能主要取决于病变冠状动脉局部单核细胞PDGF基因水平;单核细胞PDGF基因水平可作为评价冠心病患者预后好坏的指标之一。

Relation between Level Of Platelet Derived Growth Factor mRNA and Coronary Collateral Circulation in Patients with Coronary Arterial Disease

Objective:To explore the relation between level of platelet derived growth factor(PDGF)mRNA and coronary collateral circulation in coronary arterial disease(CAD).Method:The subjects were divided into three groups:control(patients without CAD,15 cases),CAD patients without coronary collateral circulation(31 cases)and CAD patients with coronary collateral circulation(18 cases).The monocyte PDGF mRNA levels were measured by RT-PCR from the blood of root aorta area and femoral.Results:1.The presence of coronary collateral circulation could significantly decrease the incidence of CHF and aneurysm(P<0.01);2.In root of aorta area,the monocyte PDGF mRNA levels increased in patients with CAD(P<0.01),especially in CAD with coronary collateral circulation(P<0.01);In femoral area,the monocyte PDGF mRNA levels increased in patients with CAD(P<0.01),there were no difference between CAD patients without coronary collateral circulation and CAD patients with coronary collateral circulation(P>0.05).Conclusion:The process of coronary collateral circulation mainly depended on monocyte PDGF mRNA level in local coronary artery lesion.The formation of coronary collateral circulation has close relation with activation of monocyte and the level of PDGF.PDGF can take as the candidate gene of CAD.