Wang Lei, Li Yuanming, Gong Xiaojin
Department of Surgery, Ward 3, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830028, P.R. China.
Department of Pathology, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830028, P.R. China.
Exp Ther Med. 2018 Jan;15(1):949-953. doi: 10.3892/etm.2017.5476. Epub 2017 Nov 9.
This study was designed to assess the relationship between changes in peripheral inflammatory factors of patients complicated with non-alcoholic fatty liver disease (NAFLD) undergoing coronary artery bypass grafting (CABG) before and after operation, and their prognosis. A total of 68 patients with stable angina pectoris treated in Xinjiang Hospital who underwent CABG at some point between August of 2013 and August of 2015 were enrolled in the study, and divided into the NAFLD group (n=31) and the non-NAFLD group (n=37) according to the presence of the condition or its absence. Peripheral blood was drawn from the patients before and at 24 h and 1 month after the operation, and the expression levels of high-sensitivity C-reactive protein (hsCRP), soluble CD40 ligand (sCD40L), intercellular adhesion molecule-1 (ICAM-1) and matrix metalloproteinase-9 (MMP-9) were measured via standard enzyme-linked immunosorbent assay. Our results showed the expression levels of hsCRP and sCD40L of patients in both groups reached a peak 24 h after operation; and there were statistically significant changes compared with the levels before the operation and at 1 month after operation (p<0.01). However, there were no statistically significant differences in the expression levels between the two groups (p>0.05). The expression levels of ICAM-1 at each time-point in both groups were increased after the operation, but the changes were not statistically significant (p>0.05). The expression levels of MMP-9 increased after the operation, and the levels at 1 month after operation were significantly higher than those before operation and at 24 h after the operation (p<0.01). Importantly, the expression levels of MMP-9 of patients in the NAFLD group at 1 month after operation were significantly higher than those of patients in the non-NAFLD group at the same time, and the differences were statistically significant (p<0.01). Finally, logistic regression analysis showed that the expression level of MMP-9 was an important influencing factor for cardiovascular events after CABG (OR=1.182, p<0.05). Based on our findings, the expression levels of inflammatory factors in peripheral blood in patients complicated with NAFLD undergoing CABG differ from those who are not complicated, and the MMP-9 levels may be closely related to the prognosis of patients complicated with NAFLD.
本研究旨在评估非酒精性脂肪性肝病（NAFLD）合并冠心病患者冠状动脉旁路移植术（CABG）前后外周血炎症因子变化及其与预后的关系。选取2013年8月至2015年8月在新疆某医院行CABG的68例稳定型心绞痛患者，根据是否合并NAFLD分为NAFLD组（n = 31）和非NAFLD组（n = 37）。于术前、术后24小时及1个月采集患者外周血，采用标准酶联免疫吸附试验检测高敏C反应蛋白（hsCRP）、可溶性CD40配体（sCD40L）、细胞间黏附分子-1（ICAM-1）和基质金属蛋白酶-9（MMP-9）的表达水平。结果显示，两组患者hsCRP和sCD40L表达水平术后24小时均达峰值，与术前及术后1个月比较差异有统计学意义（p < 0.01），但两组间表达水平差异无统计学意义（p > 0.05）。两组ICAM-1各时间点术后均升高，但差异无统计学意义（p > 0.05）。MMP-9表达水平术后升高，术后1个月显著高于术前及术后24小时（p < 0.01）。重要的是，NAFLD组患者术后1个月MMP-9表达水平显著高于非NAFLD组，差异有统计学意义（p < 0.01）。最后，Logistic回归分析显示，MMP-9表达水平是CABG术后心血管事件的重要影响因素（OR = 1.182，p < 0.05）。基于本研究结果，NAFLD合并CABG患者外周血炎症因子表达水平与未合并者不同，MMP-9水平可能与NAFLD合并患者预后密切相关。
