Objective: To explore the plasma chemokines expressions and related clinical implication in patients with Stanford type A aortic dissection (AD). Methods: We retrospectively analyzed the data of 65 patients with Stanford type A aortic dissection, hypertensive patients and 11 healthy subjects admitted in our department from October 2013 to December 2014, they were divided into four groups: NH-CON group (11 healthy subjects), H-AD group (29 AD patients with hypertension), NH-AD group (21 AD patients without hypertension), and H-CON group (14 hypertension patients). Four plasma samples from AD patients and 4 plasma samples from healthy subjects were collected randomly with random numbers table, and the levels of different chemokines were examined by protein array analysis. Then, plasma levels of chemokines including macrophage inflammatory protein 1β(MIP-1β), epithelial neutrophil activating peptide 78(ENA-78), interleukin 16(IL-16), interferon inducible protein 10(IP-10) and FMS-like tyrosine kinase 3(Flt-3) ligand were analyzed by luminex. Pearson analysis was used to determine the correlations between the chemokines and serum C reactive protein (CRP) levels. Results: Plasma levels of MIP-1β(34.0(29.3, 47.2) ng/L vs. 51.0(28.2, 80.7) ng/L, P<0.05) and ENA-78(110.5(59.1, 161.4) ng/L vs. 475.7(299.3, 837.3) ng/L, P<0.05) were significantly lower in H-AD group, while plasma IL-16 level was significantly higher in H-AD group(54.7(16.3, 187.8) ng/L vs. 17.5(11.9, 20.8) ng/L, P<0.05) than in H-CON group. Plasma levels of MIP-1β(48.3(26.4, 62.1) ng/L, P<0.05) were significantly lower in H-AD patients than in NH-AD patients. Plasma level of ENA-78 was significantly lower in NH-AD group than in NH-CON group (95.0(58.0, 155.0) ng/L vs. 257.7(85.2, 397.8) ng/L, P<0.05). The levels of IP-10 and Flt-3 ligand were similar among the 4 groups (all P>0.05). Pearson analysis showed that there were no correlation between MIP-1β(r(2)=0.01, P>0.05), ENA-78(r(2)=0.02, P>0.05), IL-16(r(2)=0.02, P>0.05), IP-10(r(2)=0.00, P>0.05), Flt-3 ligand(r(2)=0.02, P>0.05) and CRP levels in patients with Stanford type A aortic dissection. Conclusions: Lower plasma levels of MIP-1β and ENA-78 and higher plasma levels of IL-16 may associate with the occurrence and development of type A aortic dissection, but their concentrations are not correlated with serum CRP levels. There is no significant change on plasma levels of IP-10 and Flt-3 in the Stanford type A aortic dissection patients.
目的： 探讨Stanford A型主动脉夹层患者血浆趋化因子表达水平及其临床意义。 方法： 2013年10月至2014年12月，采用回顾性分析方法纳入在南京大学医学院附属鼓楼医院就诊的患者65例和健康者11名，并分为对照组(健康者11名)、合并高血压组(合并高血压的Stanford A型主动脉夹层患者29例)、不合并高血压组(不合并高血压的Stanford A型主动脉夹层患者22例)和单纯高血压组(单纯高血压患者14例)。先采用随机号码表选择4例Stanford A型主动脉夹层患者和4名健康者的血浆行蛋白芯片分析，然后根据芯片结果采用Luminex法检测各组的血浆趋化因子[包括巨噬细胞炎性蛋白1β(MIP－1β)、上皮中性粒细胞活化肽78(ENA－78)、白细胞介素16(IL－16)、干扰素诱导蛋白10(IP－10)和FMS酪氨酸激酶受体3(Flt－3)配体]水平。不同趋化因子水平与血清C反应蛋白水平的相关性采用Pearson相关性分析。 结果： 与单纯高血压组比较，合并高血压组的MIP－1β[34.0(29.3，47.2)ng/L比51.0(28.2，80.7) ng/L]和ENA－78[110.5(59.1，161.4) ng/L比475.7(299.3，837.3) ng/L]水平较低(P均<0.05)，而IL－16水平较高[54.7(16.3，187.8) ng/L比17.5(11.9，20.8) ng/L](P<0.05)。合并高血压组的MIP－1β水平低于不合并高血压组[48.3(26.4，62.1) ng/L，P<0.05]。不合并高血压组的ENA－78水平低于对照组[95.0(58.0，155.0) ng/L比257.7(85.2，397.8) ng/L，P<0.05]。4组之间的IP－10和Flt－3配体水平差异均无统计学意义(P均>0.05)。Pearson相关性分析显示，Stanford A型主动脉夹层患者的血浆MIP－1β(r(2)＝0.01，P>0.05)、ENA－78(r(2)＝0.02，P>0.05)、IL－16(r(2)＝0.02，P>0.05)、IP－10(r(2)＝0.00，P>0.05)和Flt－3配体(r(2)＝0.02，P>0.05)水平与血清C反应蛋白水平均无相关性。 结论： 血浆MIP－1β和ENA－78水平下降及IL－16水平升高可能与Stanford A型主动脉夹层的发生和发展有关，但与血清C反应蛋白水平无相关性。血浆IP－10和Flt－3配体水平在Stanford A型主动脉夹层患者中无显著变化。.
Keywords: Aneurysm, dissecting; C-reactive protein; Chemotactic factors; Hypertension.