| Objective: 1.To explore the effects and meanings of serum tumor necrosis factor related apoptosis inducing ligand(TRAIL),death receptor 5(DR5)and osteoprotegerin(OPG)in coronary heart disease.2.To detect the expression levels of TRAIL and its receptors in patients with acute myocardial infarction(AMI),as well as to investigate whether there was a dynamic evolution.Methods: 135 inpatients of cardiovascular internal medicine who received coronary angiography(CAG)examination in Yijishan hospital affiliated to the Wannan medical college from October 2016 to October 2017 were collected in our case-control study,which can be divided into three groups: 23 cases in normal group and 92 cases in angina pectoris(AP)group and 20 cases in AMI group.The angina pectoris group was divided into single lesion(39 cases)and multivessel lesions(53 cases)two subgroups,multivessel lesions group was divided into the two lesions groups(20 cases)and three lesion group(33 cases)according to the lesions of coronary angiography.The angina pectoris group was divided into stenosis < 90%(56 cases)and stenosis > 90% two subgroups(36 cases)according to the degree of stenosis.20 patients who received PCI surgery in angina pectoris group were divided into pre-PCI group and post-PCI group.Five subgroups were made on the basis of AMI patients in hospital time: immediately after admission group,12 hours group,24 hours group,72 hours group and 1 week group.Collecting and recording general clinical data and detecting the serum concentration of TRAIL and DR5 and OPG in all patients by the ELISA method;Each item of AMI patients needed to be test for 5 times according to the 5 subgroups,namely the five periods of the expression concentration of TRAIL and DR5 and OPG.Using SPSS 19.0 statistical software for all data statistical analysis,P < 0.05 was statistically difference.Results: 1.Expression level of TRAIL had a significant difference between three groups(P < 0.001).The expression level of TRAIL in AMI and AP group,higher than that of normal group(76.46±15.55 ng/L),were 94.73±12.99 ng/L and 91.99±7.95 ng/L,respectively(both P < 0.001).2.Expression level of DR5 had a significant differences between three groups(P < 0.05).The the expression level of DR5 in AMI and AP group,both higher than it in normal group,were 53.88±8.12 ng/L,53.64±3.67 ng/L,respectively(both P < 0.05).3.The expression level of OPG was statistically different between three groups(P < 0.001).While the the expression level of TRAIL in AP and AMI group were 1430.78±349.63 ng/L and 1326.39±131.07 ng/L,which were both significantly higher than that in normal group(1179.28±150.64 ng/L)(P < 0.001,respectively).4.In AMI group,the expression level of TRAIL and DR5 and OPG all had no statistical differences between 5 subgroups(P > 0.05).The expression level of troponin in 5 subgroups had statistical differences(all P < 0.001)and the expression level of 12 hours(84.66±44.66 ng/ml)and 24 hours(63.74±35.59 ng/ml)after admission was significantly higher than other groups(all P values < 0.001).5.In the AP subgroups,the expression of TRAIL and DR5 in both single and multiple lesion groups showed no significant difference while the expression of OPG in multivessel lesions group(1553.28±392.44 ng/L)were significantly higher than in the single lesion group(1264.30±180.58 ng/L).6.In the AP subgroups,the expression of TRAIL,DR5 and OPG in single,two and three lesions subgroups had statistical differences(P < 0.05,< 0.05,< 0.001),the expression level of TRAIL(99.59±12.41 ng/L)and DR5(56.52 ±7.59 ng/L)in the three lesion group were significantly higher than TRAIL(88.31±10.65 ng/L)and DR5(50.63±8.29 ng/L)in the two lesions(both P < 0.05);The expression levels of OPG in single,two,three subgroups showed a trend of gradual increase,whose average level was 1264.30±180.58 ng/L,1372.26.30±276.09 ng/L and 1662.99±414.87 ng/L,respectively.7.In AP subgroups,the expression levels of TRAIL(98.13±12.54 ng/L),DR5(57.40±7.07 ng/L)and OPG(1638.88±405.41 ng/L)in stenosis > 90% group were significantly higher than those TRAIL(92.55±12.91 ng/L),DR5(51.61±8.00 ng/L)and OPG(1297.00±226.04 ng/L)in levels stenosis < 90% group,respectively(P < 0.05,< 0.05,< 0.001).8.In AP subgroups,expression level of TRAIL,DR5 and OPG in both pre-PCI group and post-PCI group had no statistical difference(P > 0.05).9.The expression level of TRAIL and DR5 were positively correlation(r = 0.252,P = 0.007).10.The expression level of TRAIL and OPG had a positive correlation(r = 0.318,P = 0.001).11.The expression level of DR5 and OPG had a positive correlation(r = 0.302,P = 0.001).12.The expression level of OPG and coronary artery lesions had a positive correlation(r = 0.502,P < 0.001).13.In AP group,the expression of TRAIL levels and LVEF showed a negative correlation(r =-0.222,P = 0.034).14.Ordered and stepwise logistic regression analysis showed that OPG and diabetes entered the regression model.Conclusion: 1.The increased expression level of TRAIL,DR5 and OPG were observed in patients with coronary heart disease(CHD),while the expression levels of OPG and TRAIL were positive associated with range of CHD lesions and degree of stenosis in coronary.2.OPG and diabetes may be independent risk factors for coronary artery disease.3.The expression of TRAIL and its receptors(DR5,OPG)level had no dynamic evolution within one week after the AMI patients admitted to hospital. |
PDF Full Text Request