The Gene Polymorphism And Serum Content Of TNF-α In Restenosis Patients After PCI

Objective:To find the risk factors of restenosis after PCI and reveal the relationship with gene polymorphism and serum content of tumor necrosis factor-α(TNF-α).Methods:360 patients were selected in our study with reexamination PCI since October 2005 to May 2007 to investigate the relationship of the basic data for PCI operative and restenosis. On the basis of the review of coronary angiography results, patients were divided into two groups, restenosis group(n=134) and control (non-restenosis) group(n=226). On the other hand, each patient's genome DNA was extracted from blood to amplify the unique fragment of TNF-α-308G/A site by using method of PCR with specific primers. The amplicons were identified by restriction analysis with StyⅠenzyme. According to the agarose gel electrophoresis results, TNF-a genotype was invided into three types, GA(n=324),GG(n=36), AA(n=0). Serum TNF-αcontent was also quantified using ELISA method.Results:1. Using the logistic regression analysis, we found men (p=0.024), high weight (p=0.018), high lipoprotein (a) (p=0.007), target lesion site of right coronary artery (p=0.004), small vessel (diameter<3mm) (p=0.017), were significant difference in control and restenosis groups. Person has factors above was tend to restenosis after PCI.2. TNF-αgene polymorphism has GG, GA, and AA types. In this study, GAtype was 36 of 360 patients(10%), GG type was 324 of 360 patients(90%), AA type wasn't find. The GG and GA type were 119 (88.8%) and 15 (11.2%) respectively in ISR group, compared with 205 (90.7%) and 21 (9.3%) in NISR group, p=0.588,χ2=0.338。The allele frequency of A were 5.6% in ISR group and 4.6% in NISR group, meanwhile the G were 94.4% and 95.4% in two groups, p=0.598,χ2=0.32.3. The serum TNF-αcontent was 46.44±5.66pg/ml in ISR group compared with 45.83±3.65pg/ml in NISR group, p=0.797; which was 46.59±5.21pg/ml and 43.86±2.87pg/ml respectively in GA type and GG type, p=0.071. Conclusion:1. The high-risk patients can be marked by factors such as men, high weight,high lipoprotein (a), target lesion site of right coronary artery, small vessels with diameter<3mm, who need close follow-up and intensive drug therapy.2. Through the statistical analysis of polymorphism of TNF-αpromoter-308G/A site of 360 patients, we found gene polymorphism distribution of TNF-a promoter-308G/A site is consistent with the distribution of Han people but different from foreign investigation, which hinted the gene polymorphism distribution of TNF-αpromoter-308 G/A site maybe has racial differences. Meanwhile the statistical results revealed that there is no relationship between gene polymorphism of TNF-αpromoter-308G/A site and restenosis after PCI, which is similar with foreign report. There has no same investigation domestically.3. Through the statistical analysis of serum TNF-αcontent of 360 patients, we found there is no statistically significant difference in ISR and NISR groups. Thus, there is no relationship between serum TNF-αcontent and restenosis after PCI. The serum TNF-αcontent of GA type patients is higher than GG type patients, but there is no statistically difference neither. The results hinted there is no relationship between serum TNF-a content and polymorphism of TNF-a promoter-308G/A site.