The Study On Connective Tissue Growth Factor Of Action And Clinical Diagnosis Value In Formation Of Coronary Artery Stenosis

Objective: The mechanism of action of connective tissue growth factor and Insulin growth factor-1(IGF-1),Matrix Metalloproteinase 9(MMP-9),Transfer growth factor beta 1(TGF-β1) in formation of coronary artery stenosis and its clinical diagnostic value;Genetic susceptibility between single nucleotide polymorphism of rs9399005 and rs12527705 of CTGF and coronary artery stenosis. Method: System review of the correlation between CTGF and atherosclerosis was used Evidence based medicine principle and method;Two hundred and seventy partners were divided into coronary stenosis group(n=218) and normal control group(n=60) according to coronary angiography,Gensini score was accounted by result of coronary angiography;Serum concentration of CTGF, IGF-1,MMP-9,and TGF-β1 were detected by ELISA.The sensitivity, specificity, diagnostic index to evaluate the CTGF, IGF-1, MMP-9, TGF- b1 clinical value in the diagnosis of coronary artery stenosis by ROC;Regression analysis between the serum levels of marker and Gensini scores was to assess,The application of polymerase chain reaction and high-throughput sequencing to detect single nucleotide polymorphism of rs9399005 and rs12527705; By using non conditional Logstic regression analysis of rs9399005 and rs12527705 polymorphisms and Genetic susceptibility to coronary artery stenosis. Results:The five databases of Pub Med, EMBASE, CNKI, Wanfang, VIP fully searchable, included a total of 31 the most comprehensive data evidence for the literature to system review,Which indicate the relation between CTGF and stenosis of atherosclerosis Coronary artery stenosis group and the normal control has statistical significance sets of basic clinical data and CTGF, IGF-1, MMP-9, TGF-β1 serum levels, including age, smoking rate, hypertension rate, HDL, Apo A, LP(a), CRP, CTGF, IGF-1, MMP-9, TGF beta 1 difference(P < 0.05); There are significant differences in the level of serum CTGF in non coronary stenosis group and CHD group(F=88.531, P=0.000); there were statistically significant differences in double vessel group and multi vessel group, single vessel disease group(F=59.240, P=0.001);By the Spearman correlation analysis: CTGF and Gensini scores: r=0.788, P=0.000;TGF-β1:r=0.703,P=0.000;IGF-1:r=0.610,P=0.000;MMP-9:r=0.679,P=0.000; Sensitivity,specificity,respectively:CTGF:(95.3%,89.1%,457.4pg/ml),MMP-9(89.3%,83.7%,14.05ng/ml),IGF-1(86.9%,76.6%,14.34ng/ml);TGF-β1(88.3%,73.4%,147.5ng/ml); Regression equation:0.035CTGF-0.063TGFβ1+0.078IGF1+0.458MMP9-5.98. The fitness of Chi square test of polymorphic loci genotype distribution rs9399005(χ2=2.256,P=0.107) and rs12527705(χ2=3.675,P=0.276) conform to hardy Weinberg equilibrium,The rs9399005 between the two groups was statistically significant(χ2=12.903, P=0.002).The non conditional logistic analysis rs9399005 polymorphism and coronary artery stenosis of susceptibility, carrying a heterozygous mutant individuals occurred risk of coronary atherosclerotic stenosis of 1.131 times of individual wild-type and homozygous mutant is 1.416 times of the wild type allele t is C allele of 1.347 times regression models,Genotypes CC, CT and TT serum levels in: CTGF(F=3.294, P=0.039),the differences has statistical significance. Conclusion: CTGF, TGF-β1, IGF-1, MMP-9 of serum levels can be used as a diagnostic index for the diagnosis of coronary artery stenosis and the risk stratification;Gensini integral parameter model:0.035CTGF-0.063TGFβ1+0.078IGF1+0.458MMP9-5.98 can be used to evaluate the degree of coronary artery stenosis;Rs9399005 polymorphism and coronary artery stenosis associated with susceptibility.