循环内皮细胞对冠心病心血管事件的预测价值 .pdfVIP

循环内皮细胞对冠心病心血管事件的预测价值

潘家义;吴立荣;李伟;李屏;李莎;陈颖;肖良

【摘要】ObjectiveToinvestigatetheroleofthecirculatingendothelial

cells(CEC)-adirectbiomarkerofendothelialinjury,inevaluatingthe

cardiovascularriskinpatientspresentingwiththeacutecoronary

syndrome(ACS).MethodsWestudied110admittedpatientsdiagnosedas

acutecoronaryarteryand30healthycontrols(HCgroup).Cardiovascular

riskscoreswerecalculatedinallACSpatientsusingtwokindsofriskscore

systems:thethrombolysisinmyocardialinfarctionscoringsystems(TIMI)

fornon-ST-elevationmyocardialinfarction(NSTEMI)/unstableangina(UA)

pectoris,ST-elevationmyocardialinfarction(STEMI)andtheglobalregistry

ofacutecoronaryevents(GRACE)riskscoreforallACSbasedonpatients′

clinicalhistory,symptom,electrocardiogramcharacteristicchanges,

biochemicaloutcomes;CECcountingwasexecutedbyflow

cytometry.ResultsComparedwithHCgroup,theCECcountofACS

patientswassignificantlyincreased,andincreasedwiththeseverityof

disease.ThereweresignificantcorrelationbetweenCECcountsandrisk

scores(TIMIUA/NSTEMIr=0.47;TIMISTEMIr=0.64;GRACE

r=0.61,P0.05).Theareaunderthereceiver-operatingcharacteristic

curve(AUC)forthediagnosisofMI(NSTEMI/STEMI)was0.90(95%

CI:0.84~0.94,P0.01),fortheallACSwas0.89(95%

CI:0.82~0.93,P0.01).ConclusionCECcountsgoupwiththeincreasing

cardiovascularrisk,whichispossiblyaneffectivepredictivebiomarkerfor

clinicalcardiovascularevents.%目的探讨循环内皮细胞(CEC)计数成为急性冠脉

综合征(ACS)患者心血管风险预测的重要生物标志的有效性.方法研究分析了110

例ACS患者和30例健康人群作对照(HC组);根据其病史、症状、心电图、各种生

化结果,利用两种不同的冠心病风险评分系统评估ACS患者的心血管事件风险:心肌

梗死溶栓治疗临床试验(TIMI)评分评价非ST段抬高型心肌梗死(NSTEMI)/不稳定

型心绞痛(UA)以及ST段抬高型心肌梗死(STEMI);全球急性冠状动脉事件注册

(GRACE)评分评价所有冠心病;利用流式细胞仪检测静脉血CEC数.结果与HC组

比较,ACS患者组的CEC计数明显升高,并随疾病的严重程度进行性升高;CEC计数

和心血管事件风险的高低明显相关,TIMIUA/NSTEMI、TIMI/STEMI、GRACE评

分相关系数分别为0.47、0.64、0.61(P0.05);CEC诊断急性心