CD16^+单核细胞对冠心病患者OPCABG术后预后的预测价值  

Predictive value of CD16^+ monocytes for the prognosis of patients with coronary heart disease after the off-pump coronary artery bypass grafting surgery

作　　者：朱瑞[1] 张成鑫[1] 王会平[2] 李鑫[1] 沈志明 孙飞 储诚豪 葛圣林[1] Zhu Rui;Zhang Chengxin;Wang Huiping(Dept of Cardiovascular,The First Affiliated Hospital of Anhui Medical University,Hefei 230022;Dept of Hematopathology,The Second Affiliated Hospital of Anhui Medical University,Hefei 230601)

机构地区：[1]安徽医科大学第一附属医院心脏大血管外科,合肥230022 [2]安徽医科大学第二附属医院血液内科,合肥230601

出　　处：《安徽医科大学学报》2019年第9期1476-1481,共6页Acta Universitatis Medicinalis Anhui

基　　金：安徽省科技厅重点科研资助项目(编号:1301043025)

摘　　要：以155例接受非体外循环冠状动脉旁路移植术(OPCABG)的冠心病(CHD)患者为研究对象,术前检测外周血CD16^+单核细胞,随访2年,以发生主要不良心血管事件(MACE)作为观察终点,评估CD16 +单核细胞对CHD患者OPCABG术后预后的预测价值。MACE组CD16^+单核细胞占比较高( P <0.001);高CD16^+单核细胞组MACE发生率明显高于中、低位组( P <0.001);经传统心血管疾病危险因素校正后,Cox比例风险模型分析表明CD16 +单核细胞是CHD患者OPCABG术后发生MACE的独立危险因素( HR =1.071,95% CI :1.040~1.104, P <0.001);ROC曲线下面积为0.786(95% CI :0.687~0.884, P <0.001),最佳截断值41.9%,灵敏度70.8%,特异度78.6%。CD16 +单核细胞具有预测CHD患者OPCABG术后MACE的价值。155 patients with coronary heart disease(CHD) who underwent off-pump coronary artery bypass grafting(OPCABG) were selected and CD16^+ monocytes in peripheral blood were detected before operation. Major adverse cardiovascular events(MACE) were used as the primary endpoint during 2 years follow-up to evaluate the predictive value of CD16^+ monocytes for the prognosis of CHD patients after OPCABG. Compared with non-MACE patients, CD16^+ monocytes were higher in MACE patients( P <0.001). The MACE incidence in the high CD16^+ monocytes group were significantly higher than the middle CD16^+ monocytes group and low CD16^+ monocytes group( P <0.001). Cox proportional hazards model analysis showed that CD16^+ monocytes were the independent risk factors for MACE in CHD patients after adjustment for the traditional cardiovascular risk factors( HR =1.071,95% CI :1.040~1.104, P <0.001). The area under ROC curve was 0.786(95% CI : 0.687~0.884, P <0.001) and the optimal cut-off point was 41.9%(70.8% sensitivity, 78.6% specificity). CD16^+ monocytes can serve as a marker to predict the occurrence of MACE in CHD patients after the OPCABG.

关 键 词：冠心病 单核细胞 非体外循环冠状动脉旁路移植术 预后 

分 类 号：R604[医药卫生—外科学]