血红素加氧酶1在颈动脉重度狭窄支架植入术后的变化及意义
|
摘要
目的观察颈动脉重度狭窄患者行支架植入治疗术前、术后血红素加氧酶1(heme oxygenase 1,HO-1)水平和中性粒细胞-淋巴细胞比值(neutrophil lymphocyte ratio,NLR)的变化,探讨HO-1变化的原因和在其中发挥的作用。方法四川省人民医院神经内科行颈动脉重度狭窄的44例住院患者作为观察组,另选择无颈动脉狭窄的30例患者作为对照组。用Elisa检测两组术前,观察组术前及术后1、3天的HO-1的水平变化,检测术前与术后的中性粒细胞和淋巴细胞数,计算比值。结果两组术前HO-1水平差异无统计学意义(P> 0. 05);观察组术后1、3天HO-1水平与术前比较明显升高(P <0. 001),且术后第3天比术后第1天升高(P <0. 05),观察组术后中性粒细胞-淋巴细胞比值较术前升高(P <0. 05)。结论颈动脉重度狭窄患者动脉介入治疗可改善颅内动脉供血,可升高患者保护性因子血红素加氧酶1(HO-1)水平,炎性反应参与其中。
Objective To observe the changes of heme oxygenase-1( HMOX-1) level and neutrophil-lymphocyte ratio in patients with severe carotid artery stenosis before and after stent implantation and explore the cause of the changes and the role of HMOX-1.Methods Forty-four hospitalized patients with severe carotid artery stenosis at the department of neurology of the Sichuan Provincial People's Hospital were selected as observation group and 30 healthy patients as control group. The changes of HMOX-1 levels were measured by using an ELISA before operation in both group and after one day and 3 days of operation in the observation group. The number of neutrophils and lymphocytes before and after operation was also measured and the ratio was calculated.Results There was no significant difference in HMOX-1 level between the preoperative observation group and the healthy control group( P > 0. 05).However,the level of HMOX-1 in the observation group was significantly higher than that before operation on the first day and the third day after operation( P < 0. 01),and the third day was higher than the first day. The ratio of neutrophils to lymphocytes in the observation group was increased when compared to before operation( P < 0. 05).Conclusion The interventional treatment of severe carotid artery stenosis can improve intracranial artery blood supply and increase the level of HMOX-1,a protective factor.Inflammatory reaction may be also involved.
Objective To observe the changes of heme oxygenase-1( HMOX-1) level and neutrophil-lymphocyte ratio in patients with severe carotid artery stenosis before and after stent implantation and explore the cause of the changes and the role of HMOX-1.Methods Forty-four hospitalized patients with severe carotid artery stenosis at the department of neurology of the Sichuan Provincial People's Hospital were selected as observation group and 30 healthy patients as control group. The changes of HMOX-1 levels were measured by using an ELISA before operation in both group and after one day and 3 days of operation in the observation group. The number of neutrophils and lymphocytes before and after operation was also measured and the ratio was calculated.Results There was no significant difference in HMOX-1 level between the preoperative observation group and the healthy control group( P > 0. 05).However,the level of HMOX-1 in the observation group was significantly higher than that before operation on the first day and the third day after operation( P < 0. 01),and the third day was higher than the first day. The ratio of neutrophils to lymphocytes in the observation group was increased when compared to before operation( P < 0. 05).Conclusion The interventional treatment of severe carotid artery stenosis can improve intracranial artery blood supply and increase the level of HMOX-1,a protective factor.Inflammatory reaction may be also involved.
引文
[1]李宏建.颈动脉内膜切除术与支架置入术在长期卒中预防方面的持久性和安全性相同[J].国际脑血管病杂志,2016,24(3):288-288.
[2]Tuma RF,Steffens S.Targeting the endocannabinod system to limit myocardial and cerebral ischemic and reperfusion injury.[J].Current Pharmaceutical Biotechnology,2012,13(1):46-58.
[3]Wang YF,Gu YT,Qin GH,et al.Curcumin ameliorates the permeability of the blood-brain barrier during hypoxia by upregulating heme oxygenase-1 expression in brain microvascular endothelial cells[J].Journal of Molecular Neuroscience Mn,2013,51(2):344-351.
[4]中华医学会放射学分会介入学组.颈动脉狭窄介入治疗操作规范(专家共识)[J].中华放射学杂志,2010,44(9):995-998.
[5]Kao HL,Lin MS,Wu WC,et al.Improvement of Cerebral Glucose Metabolism in Symptomatic Patients With Carotid Artery Stenosis After Stenting[J].Clinical Nuclear Medicine,2015,40(9):701-707.
[6]Avirame K,Lesemann A,List J,et al.Cerebral autoregulation and brain networks in occlusive processes of the internal carotid artery.[J].J Cereb Blood Flow Metab,2015,35(2):240-247
[7]Chaer RA,Shen J,Rao A,et al.Cerebral reserve is decreased in elderly patients with carotid stenosis.[J].Journal of Vascular Surgery,2010,52(3):569-575.
[8]Gaudiello F,Colangelo V,Bolacchi F,et al.Sixty-four-section CT cerebral perfusion evaluation in patients with carotid artery stenosis before and after stenting with a cerebral protection device[J].Ajnr A-merican Journal of Neuroradiology,2008,29(5):919.
[9]Zhang W,Song JK,Yan R,et al.Diterpene ginkgolides protect against cerebral ischemia/reperfusion damage in rats by activating Nrf2 and CREB through PI3K/Akt signaling[J].Acta PharmacologicaSinica,2018,39(8):1259-1272.
[10]Dong B,Zhang Z,Xie K,et al.Hemopexin promotes angiogenesis via up-regulating HO-1 in rats after cerebral ischemia-reperfusion injury[J].Bmc Anesthesiology,2018,18(1):2.
[11]Ramagiri S,Taliyan R.Protective effect of remote limb post conditioning via upregulation of heme-oxygenase-1/BDNF pathway in rat model of cerebral ischemic reperfusion injury.[J].Brain Research,2017,1669:44-54.
[12]Yaidikar L,Thakur S.Punicalagin,attenuated cerebral ischemiareperfusion insult via inhibition of proinflammatory cytokines,upregulation of Bcl-2,down-regulation of Bax,and caspase-3[J].Molecular&Cellular Biochemistry,2015,402(1-2):141-148.
[13]Chen L,Wang L,Zhang X,et al.The protection by octreotide against experimental ischemic stroke:up-regulated transcription factor Nrf2,HO-1 and down-regulated NF-κB expression.[J].Brain Research,2012,1475:80-87.
[14]Dai H,Wang M,Patel PN,et al.Preconditioning with the BKCa Channel Activator NS-1619 Prevents Ischemia/Reperfusion-Induced Inflammation and Mucosal Barrier Dysfunction:ROS and HO-1.[J].Am J Physiol Heart Circ Physiol,2017,313(5):620.
[15]Ding Y,Chen M,Wang M,et al.Posttreatment with 11-Keto-β-Boswellic Acid Ameliorates Cerebral Ischemia-Reperfusion Injury:Nrf2/HO-1 Pathway as a Potential Mechanism.[J].Molecular Neurobiology,2015,52(3):1430-1439.
[16]Li L,Du G,Wang D,et al.Overexpression of Heme Oxygenase-1 in Mesenchymal Stem Cells Augments Their Protection on Retinal Cells In Vitro and Attenuates Retinal Ischemia/Reperfusion Injury In Vivo against Oxidative Stress[J].Stem Cells International,2017,2017:4985323.
[17]Fang Y,Liu X,Zhao L,et al.RhGLP-1(7-36)protects diabetic rats against cerebral ischemia-reperfusion injury via up-regulating expression of Nrf2/HO-1 and increasing the activities of SOD.[J].Korean Journal of Physiology&Pharmacology Official Journal of the Korean Physiological Society&the Korean Society of Pharmacology,2017,21(5):475.
[18]Kuo PC,Yu IC,Scofield BA,et al.3 h-1,2-Dithiole-3-thione as a novel therapeutic agent for the treatment of ischemic stroke through Nrf2 defense pathway[J].Brain Behavior&Immunity,2017,62:180-192.
[19]Peng B,Zhao P,Lu YP,et al.Z-ligustilide activates the Nrf2/HO-1pathway and protects against cerebral ischemia-reperfusion injury in vivo and in vitro[J].Brain Research,2013,1520(32):168-177.
[20]Wang P,Liang X,Lu Y,et al.MicroRNA-93 Downregulation Ameliorates Cerebral Ischemic Injury Through the Nrf2/HO-1 Defense Pathway.[J].Neurochemical Research,2016,41(10):1-9.
[21]Wada H,Dohi T,Miyauchi K,et al.Pre-procedural neutrophil-tolymphocyte ratio and long-term cardiac outcomes after percutaneous coronary intervention for stable coronary artery disease[J].Atherosclerosis,2017,8(18):35-40.
[22]Hyun YM,Hong CW.Deep insight into neutrophil trafficking in various organs[J].Journal of Leukocyte Biology,2017,102(3):617-629.
[23]Guo Z,Yu S,Chen X,et al.Suppression of NLRP3 attenuates hemorrhagic transformation after delayed rt PA treatment in thromboembolic stroke rats:Involvement of neutrophil recruitment[J].Brain Research Bulletin,2017,137:229-240.
[24]Guo Z,Yu S,Xiao L,et al.Dynamic change of neutrophil to lymphocyte ratio and hemorrhagic transformation after thrombolysis in stroke[J].Journal of Neuroinflammation,2016,13(1):199.
[25]Lou J,Cao G,Li R,et al.β-Caryophyllene Attenuates Focal Cerebral Ischemia-Reperfusion Injury by Nrf2/HO-1 Pathway in Rats.[J].Neurochemical Research,2016,41(6):1291-1304.
[2]Tuma RF,Steffens S.Targeting the endocannabinod system to limit myocardial and cerebral ischemic and reperfusion injury.[J].Current Pharmaceutical Biotechnology,2012,13(1):46-58.
[3]Wang YF,Gu YT,Qin GH,et al.Curcumin ameliorates the permeability of the blood-brain barrier during hypoxia by upregulating heme oxygenase-1 expression in brain microvascular endothelial cells[J].Journal of Molecular Neuroscience Mn,2013,51(2):344-351.
[4]中华医学会放射学分会介入学组.颈动脉狭窄介入治疗操作规范(专家共识)[J].中华放射学杂志,2010,44(9):995-998.
[5]Kao HL,Lin MS,Wu WC,et al.Improvement of Cerebral Glucose Metabolism in Symptomatic Patients With Carotid Artery Stenosis After Stenting[J].Clinical Nuclear Medicine,2015,40(9):701-707.
[6]Avirame K,Lesemann A,List J,et al.Cerebral autoregulation and brain networks in occlusive processes of the internal carotid artery.[J].J Cereb Blood Flow Metab,2015,35(2):240-247
[7]Chaer RA,Shen J,Rao A,et al.Cerebral reserve is decreased in elderly patients with carotid stenosis.[J].Journal of Vascular Surgery,2010,52(3):569-575.
[8]Gaudiello F,Colangelo V,Bolacchi F,et al.Sixty-four-section CT cerebral perfusion evaluation in patients with carotid artery stenosis before and after stenting with a cerebral protection device[J].Ajnr A-merican Journal of Neuroradiology,2008,29(5):919.
[9]Zhang W,Song JK,Yan R,et al.Diterpene ginkgolides protect against cerebral ischemia/reperfusion damage in rats by activating Nrf2 and CREB through PI3K/Akt signaling[J].Acta PharmacologicaSinica,2018,39(8):1259-1272.
[10]Dong B,Zhang Z,Xie K,et al.Hemopexin promotes angiogenesis via up-regulating HO-1 in rats after cerebral ischemia-reperfusion injury[J].Bmc Anesthesiology,2018,18(1):2.
[11]Ramagiri S,Taliyan R.Protective effect of remote limb post conditioning via upregulation of heme-oxygenase-1/BDNF pathway in rat model of cerebral ischemic reperfusion injury.[J].Brain Research,2017,1669:44-54.
[12]Yaidikar L,Thakur S.Punicalagin,attenuated cerebral ischemiareperfusion insult via inhibition of proinflammatory cytokines,upregulation of Bcl-2,down-regulation of Bax,and caspase-3[J].Molecular&Cellular Biochemistry,2015,402(1-2):141-148.
[13]Chen L,Wang L,Zhang X,et al.The protection by octreotide against experimental ischemic stroke:up-regulated transcription factor Nrf2,HO-1 and down-regulated NF-κB expression.[J].Brain Research,2012,1475:80-87.
[14]Dai H,Wang M,Patel PN,et al.Preconditioning with the BKCa Channel Activator NS-1619 Prevents Ischemia/Reperfusion-Induced Inflammation and Mucosal Barrier Dysfunction:ROS and HO-1.[J].Am J Physiol Heart Circ Physiol,2017,313(5):620.
[15]Ding Y,Chen M,Wang M,et al.Posttreatment with 11-Keto-β-Boswellic Acid Ameliorates Cerebral Ischemia-Reperfusion Injury:Nrf2/HO-1 Pathway as a Potential Mechanism.[J].Molecular Neurobiology,2015,52(3):1430-1439.
[16]Li L,Du G,Wang D,et al.Overexpression of Heme Oxygenase-1 in Mesenchymal Stem Cells Augments Their Protection on Retinal Cells In Vitro and Attenuates Retinal Ischemia/Reperfusion Injury In Vivo against Oxidative Stress[J].Stem Cells International,2017,2017:4985323.
[17]Fang Y,Liu X,Zhao L,et al.RhGLP-1(7-36)protects diabetic rats against cerebral ischemia-reperfusion injury via up-regulating expression of Nrf2/HO-1 and increasing the activities of SOD.[J].Korean Journal of Physiology&Pharmacology Official Journal of the Korean Physiological Society&the Korean Society of Pharmacology,2017,21(5):475.
[18]Kuo PC,Yu IC,Scofield BA,et al.3 h-1,2-Dithiole-3-thione as a novel therapeutic agent for the treatment of ischemic stroke through Nrf2 defense pathway[J].Brain Behavior&Immunity,2017,62:180-192.
[19]Peng B,Zhao P,Lu YP,et al.Z-ligustilide activates the Nrf2/HO-1pathway and protects against cerebral ischemia-reperfusion injury in vivo and in vitro[J].Brain Research,2013,1520(32):168-177.
[20]Wang P,Liang X,Lu Y,et al.MicroRNA-93 Downregulation Ameliorates Cerebral Ischemic Injury Through the Nrf2/HO-1 Defense Pathway.[J].Neurochemical Research,2016,41(10):1-9.
[21]Wada H,Dohi T,Miyauchi K,et al.Pre-procedural neutrophil-tolymphocyte ratio and long-term cardiac outcomes after percutaneous coronary intervention for stable coronary artery disease[J].Atherosclerosis,2017,8(18):35-40.
[22]Hyun YM,Hong CW.Deep insight into neutrophil trafficking in various organs[J].Journal of Leukocyte Biology,2017,102(3):617-629.
[23]Guo Z,Yu S,Chen X,et al.Suppression of NLRP3 attenuates hemorrhagic transformation after delayed rt PA treatment in thromboembolic stroke rats:Involvement of neutrophil recruitment[J].Brain Research Bulletin,2017,137:229-240.
[24]Guo Z,Yu S,Xiao L,et al.Dynamic change of neutrophil to lymphocyte ratio and hemorrhagic transformation after thrombolysis in stroke[J].Journal of Neuroinflammation,2016,13(1):199.
[25]Lou J,Cao G,Li R,et al.β-Caryophyllene Attenuates Focal Cerebral Ischemia-Reperfusion Injury by Nrf2/HO-1 Pathway in Rats.[J].Neurochemical Research,2016,41(6):1291-1304.