非ST段抬高型急性冠状动脉综合征患者血清CD137水平及其与预后的关系
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(江苏大学附属医院心内科,江苏省镇江市 212001)

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王小东,硕士,主治医师,研究方向为冠心病与心力衰竭的发病机制、诊断与治疗,E-mail为wangxd43102405@sina.com。

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镇江市重点研发计划社会发展项目(SH2017031)


Serum level and prognostic significance of CD137 in patients with non-ST-segment elevation acute coronary syndrome
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Department of Cardiology, the Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu 212001, China)

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    摘要:

    目的 探讨非ST段抬高型急性冠状动脉综合征(NSTE-ACS)患者血清白细胞分化抗原137(CD137)水平,评估其在NSTE-ACS患者预后中的价值。方法 将122例住院患者分成两组:NSTE-ACS组(n=93)和对照组(n=29)。根据GRACE评分将NSTE-ACS组分为3个亚组:低危组、中危组、高危组。检测各组心肌肌钙蛋白(cTnI)、脑利钠肽(BNP)及其他生化指标;采用酶联免疫吸附测定法检测血清CD137水平。随访所有患者1年内主要不良心脏事件(MACE)。使用受试者工作特征曲线(ROC)分析血清CD137水平对NSTE-ACS患者中期预后的价值。结果 与对照组相比,NSTE-ACS组各亚组血清CD137水平均明显增高(P<0.01)。NSTE-ACS组各亚组中,高危组血清CD137水平较低危组、中危组显著升高(P<0.05)。血清CD137水平与GRACE评分呈正相关(r=0.867,P<0.01),与cTnI、BNP水平亦呈正相关(r值分别为0.942、0.945,均P<0.01)。NSTE-ACS组1年MACE发生率较对照组明显增加(P<0.01),血清CD137水平与MACE发生率呈正相关(r=0.324,P<0.01)。CD137预测NSTE-ACS患者中期发生MACE的ROC曲线下面积为0.847(95%CI 0.718~0.918,P<0.01),敏感度和特异度分别为80.0%和79.4%。结论 检测血清CD137水平有助于对NSTE-ACS患者进行危险分层,对NSTE-ACS患者的预后判断有一定的临床价值。

    Abstract:

    Aim To investigate the serum level of cluster of differentiation 137 (CD137) in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and evaluate its prognostic value in patients with NSTE-ACS.Methods 122 hospitalized patients were divided into two groups:NSTE-ACS group (n=93) and control group (n=29).According to GRACE score, NSTE-ACS group was divided into three subgroups:low-risk group, medium-risk group and high-risk group. Cardiac troponin I (cTnI), brain natriuretic peptide (BNP) and other biochemical indicators were measured in each group. The serum level of CD137 was determined by enzyme-linked immunosorbent assay. Major adverse cardiac events (MACE) were followed up for 1 year in all patients. Receiver operating characteristic curve (ROC) was used to evaluate the value of serum CD137 level in mid-term prognosis of NSTE-ACS patients. Results Compared with the control group, the serum CD137 level increased significantly in each subgroup of NSTE-ACS group (P<0.01). Among the subgroups of NSTE-ACS group, the serum CD137 level in high-risk group was significantly higher than that in low-risk group and medium-risk group (P<0.05). Serum CD137 level was positively correlated with GRACE score (r=0.867, P<0.01), and it was also positively correlated with cTnI and BNP levels (r value was 0.942 and 0.945, respectively, both P<0.01). The incidence of MACE in NSTE-ACS group was significantly higher than that in control group in one year (P<0.01), and serum CD137 level was positively correlated with the incidence of MACE (r=0.324, P<0.01). The area under the ROC curve of CD137 predicting mid-term MACE in NSTE-ACS patients was 0.847 (95%CI 0.718-0.918, P<0.01), and the sensitivity and specificity were 80.0% and 79.4% respectively. Conclusion Detection of serum CD137 level is helpful for risk stratification of patients with NSTE-ACS and has certain clinical value for prognosis judgement of patients with NSTE-ACS.

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王小东,寇玲.非ST段抬高型急性冠状动脉综合征患者血清CD137水平及其与预后的关系[J].中国动脉硬化杂志,2018,26(12):1266~1269.

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  • 收稿日期:2017-12-01
  • 最后修改日期:2018-11-15
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  • 在线发布日期: 2018-12-27