摘要
目的研究急性冠状动脉综合征(ACS)患者外周血内皮细胞微粒(EMP)与辅助性T细胞17(Th17)/调节性T细胞(Treg)的关系及对患者预后的预测价值。方法选取我院收治的442例老年ACS患者,收集患者一般资料,检测外周血中EMP、Th17/Treg水平。随访2年,统计患者终点事件。以EMP水平中位数为临界值,将患者分为高水平组(210例)、低水平组(232例)。采用Pearson相关性分析EMP与Th17/Treg的相互关系,采用ROC曲线分析及Cox比例风险模型分析外周血中EMP对临床终点事件发生的影响。结果低水平组年龄、糖尿病比例及Th17/Treg比值明显低于高水平组[(70.56±1.78)岁vs(71.89±1.85)岁、26.72%vs 37.14%及2.65±0.37 vs 3.17±0.39],差异有统计学意义(P<0.05,P<0.01)。Pearson相关性分析显示,外周血EMP水平与Th17/Treg比值呈正相关(r=0.738,P<0.01)。随访2年,低水平组、高水平组分别有4例、2例患者脱组。高水平组患者的全因死亡显著高于低水平组(16.35%vs 7.89%,P=0.007),Cox回归分析显示,基线EMP水平升高可增加全因死亡风险(P<0.05)。ROC曲线分析显示,EMP预测全因死亡的ROC曲线下面积为0.817,最佳截断值为1.67个/L,特异性和敏感性分别为82.69%、76.56%。结论ACS患者外周血中EMP水平与Th17/Treg比值呈正相关,EMP水平升高可增加全因死亡风险,可作为评估ACS患者不良预后的参考指标。
Objective To study the relationship between peripheral EMP and Th17/Treg in acute coronary syndrome(ACS)patients and the value of peripheral EMP in predicting their outcome.Methods Four hundred and forty-four elderly ACS patients admitted to our hospital were divided into high peripheral EMP level group(n=210)and low peripheral EMP level group(n=232).The patients were followed up for 2 years,during which their general data were recorded and their peripheral EMP levels and the Th17/Treg ratio were measured.The relationship between peripheral EMP and Th17/Treg was analyzed by Pearson correlation analysis.The effect of peripheral EMP on clinical end-point events was analyzed by Kaplan-Meier curve analysis and Cox proportional harzards model analysis respectively.Results The age was significantly younger,the incidence of DM and the Th17/Treg ratio were significantly lower in low peripheral EMP level group than in high peripheral EMP level group(70.56±1.78 years vs 71.89±1.85 years,26.72%vs 37.14%,2.65±0.37 vs 3.17±0.39,P<0.05,P<0.01).Pearson correlation analysis showed that the peripheral EMP level was positively related with the Th17/Treg ratio(r=0.738,P<0.01).Four patients withdrewed from the high peripheral EMP level group and 2 patients withdrewed from the low peripheral EMP level group during the 2-year follow-up period.The all-cause mortality was significantly higher in high peripheral EMP level group than in low peripheral EMP level group(16.35%vs 7.89%,P=0.007).Cox proportional harzards model analysis demonstrated that elevated baseline peripheral EMP level increased the risk of all-cause death(P<0.05).ROC curve analysis displayed that the AUC for peripheral EMP in predicting the all-cause death was 0.817 with an optimal cut-off value of 1.67/L,a specificity of 82.69%,and a sensitivity of 76.56%.Conclusion The peripheral EMP level is positively related with the Th17/Treg ratio in ACS patients.Elevated peripheral EMP level can increase the risk of all-cause death and can thus be used as a reference index i
作者
符史健
吴清松
张运涛
Fu Shijian;Wu Qingsong;Zhang Yuntao(Deoartment of Cardiology,Haikou No.4 People's Hospital,Haikou 571100,Hainan Province,China)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2020年第11期1178-1181,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
