CD4^(+)TIM-3^(+)T细胞、CD4^(+)CD45RA^(+)T细胞水平与ACS患者GRACE评分的关系  

Relationship between CD4^(+)TIM-3^(+)T cell,CD4^(+)CD45RA^(+)T cell levels and GRACE scores in ACS patients

作　　者：李樱 黄媛 陈献 王亦文[4] LI Ying;HUANG Yuan;CHEN Xian;WANG Yiwen(Department of Military General Medicine,Armed Police Characteristic Medical Center,Tianjin 300162,China;Department of Clinical Laboratory,Armed Police Logistics College,Tianjin 300162,China;Department of Emergency Medicine,Armed Police Characteristic Medical Center,Tianjin 300162,China;Department of Cardiac Function,First Hospital of Hebei Medical University,Shijiazhuang,Hebei 050000,China)

机构地区：[1]武警特色医学中心军人全科医学科,天津300162 [2]武警后勤学院临床医学系,天津300162 [3]武警特色医学中心急诊医学科,天津300162 [4]河北医科大学第一医院心脏中心心功能科,河北石家庄050000

出　　处：《国际检验医学杂志》2022年第5期601-606,共6页International Journal of Laboratory Medicine

基　　金：河北省卫生健康委员会重点科技研究计划(20190472)。

摘　　要：目的探讨CD4^(+)TIM-3^(+)T细胞、CD4^(+)CD45RA^(+)T细胞水平与急性冠状动脉综合征(ACS)患者全球急性冠状动脉事件注册(GRACE)评分之间的关系。方法选取2018年3月至2020年3月武警特色医学中心收治的212例ACS患者作为研究组,并以同期168例非冠心病检查者作为对照组,根据GRACE评分结果对ACS组患者病情进行分级,分为低危组(GRACE<109分,68例)、中危组(109分≤GRACE≤140分,62例)以及高危组(GRACE>140分,82例)。检测各组CD4^(+)TIM-3^(+)T细胞、CD4^(+)CD45RA^(+)T细胞水平。应用Pearson相关性分析CD4^(+)TIM-3^(+)T细胞、CD4^(+)CD45RA^(+)T细胞水平与ACS患者GRACE评分之间相关性,并应用受试者工作特征(ROC)曲线分析CD4^(+)TIM-3^(+)T细胞、CD4^(+)CD45RA^(+)T细胞水平诊断ACS患者的价值。结果研究组ACS患者生化检查指标总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、心肌肌钙蛋白I(cTnI)、脑利钠肽前体(Pro-BNP)、肌酸激酶同工酶(CK-MB)以及CD4^(+)CD45RA^(+)T细胞、CD4^(+)TIM-3^(+)T细胞水平较对照组均明显升高,高密度脂蛋白水平(HDL)较对照组降低(P<0.05);且高、中、低危组3组ACS患者间生化指标和CD4^(+)TIM-3^(+)T细胞、CD4^(+)CD45RA^(+)T细胞水平差异均有统计学意义(P<0.05)。Pearson相关分析显示,ACS患者的CD4^(+)TIM-3^(+)T细胞水平、CD4^(+)CD45RA^(+)T细胞水平均与GRACE评分呈正相关(r=0.644、0.518,P<0.05)。ROC曲线分析显示,CD4^(+)TIM-3^(+)T细胞诊断高危ACS患者最佳截断值为0.129,曲线下面积为0.856(95%CI:0.790~0.910),灵敏度、特异度分别为79.27%、78.46%。CD4^(+)CD45RA^(+)T诊断诊断高危ACS患者最佳截断值为0.165,曲线下面积分别为0.837(95%CI:0.874~0.901),灵敏度、特异度分别为75.61%、80.77%。且低CD4^(+)TIM-3^(+)T细胞组和低CD4^(+)CD45RA^(+)T细胞组患者发生院内心脏不良事件发生率分别明显高于高CD4^(+)TIM-3^(+)T细胞组和高CD4^(+)CD45RA^(+)T细胞组(P<0.05)。结论ACS患者CD4^(+)CD45RAObjective To explore the relationship between CD4^(+)TIM-3^(+)T cell,CD4^(+)CD45RA^(+)T cell levels and acute coronary syndrome(ACS)patients'Global Register of Acute Coronary Events(GRACE)score.Methods A total of 212 patients with ACS admitted to Armed Police Characteristic Medical Center from March 2018 to March 2020 were selected as the study group,and 168 examiners with non-coronary heart disease during the same period were selected as control group.According to the GRACE score results,the ACS group were classified and divided into low-risk group(GRACE<109 points,68 cases),intermediate-risk group(109≤GRACE≤140 points,62 cases),and high-risk group(GRACE>140 points,82 cases).The levels of TIM-3^(+)CD4^(+)T cells,CD4^(+)CD45RA^(+)T cells in each group were detected.Pearson correlation was used to evaluate the correlation between CD4^(+)TIM-3^(+)T cells,CD4^(+)CD45RA^(+)T cell levels and GRACE scores in ACS patients,and receiver operating characteristic(ROC)curve was used to analyze CD4^(+)TIM-3^(+)T cell,CD4^(+)CD45RA^(+)T cell level in predicting the diagnostic value of ACS patients.Results The levels of biochemical indicators total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL),cardiac troponin I(cTnI),N-terminal pro brain natriuretic peptide(Pro-BNP),creatine kinase isoenzyme(CK-MB)and CD4^(+)CD45RA^(+)T cells and CD4^(+)TIM-3^(+)T cells in the study group were significantly higher than those in the control group,and high density lipoprotein(HDL)was lower than that in the control group(P<0.05).In addition,there were significant differences in biochemical indicators and CD4^(+)TIM-3^(+)T cell,CD4^(+)CD45RA^(+)T cell levels among the high-risk,intermediate-risk,and low-risk groups(P<0.05).Pearson correlation analysis showed that the level of CD4^(+)TIM-3^(+)T cells and the level of CD4^(+)CD45RA^(+)T cells in ACS patients were significantly positively correlated with GRACE score(r=0.644,0.518,P<0.05).ROC curve analysis showed that the cut-off value of CD4^(+)TIM-3^(+)T for the diagnosis of hig

关 键 词：急性冠状动脉综合征 CD4^(+)TIM-3^(+)T细胞 CD4^(+)CD45RA^(+)T细胞 全球急性冠状动脉事件注册评分 

分 类 号：R541.4[医药卫生—心血管疾病]