血清ALDH2和NLRP3活性水平在冠心病不同血管病变程度中的变化

目的通过检测血清线粒体乙醛脱氢酶2（ALDH2）及核苷酸结合寡聚化结构域样受体蛋白3（nucleotide-binding oligomerization domain-like receptor protein 3，NLRP3）活性水平，分析血清ALDH2和NLRP3与冠心病（CHD）不同病变程度之间的相关性，探讨二者在CHD发生、发展中的变化规律。方法选择因胸痛入院并行冠脉造影检查的病人170例，其中冠状动脉（冠脉）造影明确诊断为CHD病人133例，同期冠脉造影正常者37例（对照组）。133例CHD病人按照冠脉狭窄严重程度分成轻度狭窄组（< 50%，is-CHD组）19例、中度狭窄组（50%~75%，ms-CHD组）41例和严重狭窄组（≥75%，ss-CHD组）73例。应用酶联免疫吸附实验检测血清中ALDH2及NLRP3活性水平，分析在有无CHD及冠脉不同病变程度下ALDH2和NLRP3活性差异，探讨ALDH2及NLRP3活性水平与CHD发生、发展的关系，采用Pearson相关性分析ALDH2和NLRP3的血清学影响因素。结果CHD组血肌酐水平高于对照组和ms-CHD组（P < 0.05），高密度脂蛋白在ss-CHD组中明显低于对照组（P < 0.01），ms-CHD和ss-CHD组淋巴/单核细胞低于is-CHD组（P < 0.05）。is-CHD组、ms-CHD组和ss-CHD组血清ALDH2水平均较对照组减低（P < 0.05~P < 0.01），并且随着冠脉狭窄严重程度的加重而逐渐减低（P < 0.01）；而血清NLRP3水平随着冠脉病变程度加重其含量逐渐升高（P < 0.01），且两者之间呈正相关关系（P < 0.05）。随着CHD病变支数的增加ALDH2逐渐下降（P < 0.01），而NLRP3水平逐渐增加（P < 0.05），以NLRP3变化为显著。血清ALDH2水平与Gensini评分呈明显负相关关系（r=-0.247，P < 0.01），而NLRP3水平与Gensini评分呈明显正相关关系（r=0.477，P < 0.01）。血清ALDH2与LDL呈负相关关系（r=-0.220，P < 0.05）；而血清NLRP3与ALDH2呈负相关关系（r=-0.201，P < 0.05）。结论随着冠脉病变程度加重，血清ALDH2水平逐渐降低，血清NLRP3水平逐渐升高，两者间存在一定的线性相关。

Changes of the serum ALDH2 and NLRP3 activity levels in different degrees of coronary artery disease

ObjectiveTo detect the activity levels of serum mitochondrial acetaldehyde dehydrogenase 2 (ALDH2) and nucleotide-binding oligomerization domain-like receptors protein 3 (NLRP3), analyze the correlations between ALDH2, NLRP3 and different courses of coronary heart disease (CHD), and explore the change rule of both in the occurrence and development of CHD.MethodsA total of 170 chest pain patients detected by coronary angiography were investigated, and 133 CHD patients and 37 normal patients (control group) were identified.One hundred and thirty-three CHD patients were divided into the mild stenosis group (19 cases with stenosis deree of < 50%, is-CHD group), moderate stenosis group (41 cases degree of stenosis with 50% to 75%, ms-CHD group) and severe stenosis group (73 cases with stenosis degree of ≥75%, ss-CHD group) according to the severity of coronary artery stenosis.The activity levels of ALDH2 and NLRP3 in all cases were detected using enzyme-linked immunosorbent assay.The differences of the activity levels of ALDH2 and NLRP3 in CHD patients with different degrees of disease were analyzed, the correlations between activity levels of ALDH2, NLRP3 and occurrence, development of CHD were disscussed.The serological influencing factors of ALDH2 and NLRP3 were analyzed using the Pearson correlation analysis.ResultsThe serum level of creatinine in CHD group was higher than that in control group and ms-CHD group (P < 0.05), the high-density lipoprotein level in ss-CHD group was significantly lower than that in control group (P < 0.01), while the lymphocyte/monocytes in ms-CHD group and ss-CHD group were lower than that in the is-CHD group (P < 0.05).The serum levels of ALDH2 in ms-CHD and ss-CHD groups were lower than that in control group, which gradually decreased with the aggravation of the severity of coronary artery stenosis (P < 0.05-P < 0.01), while the serum level of NLRP3 gradually increased with the aggravation of the degree of coronary artery disease (P < 0.01), and there was a positive correlation between both (P < 0.05).With the increasing of the number of CHD lesions, the level of ALDH2 gradually decreased (P < 0.01), while the level of NLRP3 gradually increased (P < 0.05), and the change of NLRP3 was significant.The serum level of ALDH2 was negatively correlated with Gensini score (r=-0.247, P < 0.01), while the NLRP3 level was positively correlated with Gensini score (r=0.477, P < 0.01).The serum level of ALDH2 was negatively correlated with LDL (r=-0.220, P < 0.05) and the serum level of NLRP3 was negatively correlated with ALDH2 (r=-0.201, P < 0.05).ConclusionWith the aggravation of coronary artery disease, the serum level of ALDH2 gradually decreases, the serum level of NLRP3 gradually increases, and there was a certain correlation between them.