冠心病患者冠脉斑块稳定性与血小板趋化因子水平的关系  

Relationship between Coronary Plaque Stability and Platelet Chemokines in Patients with Coronary Heart Disease

作　　者：王海强 王磊[2] WANG Hai-qiang;WANG Lei(No.986 Hospital of the Chinese People's Liberation Army Air Force,Xi'an Shaanxi 719000)

机构地区：[1]中国人民解放军空军第九八六医院心血管内科,陕西西安719000 [2]西安市中心医院心内科,陕西西安710003

出　　处：《医学临床研究》2022年第9期1329-1331,1335,共4页Journal of Clinical Research

基　　金：陕西省分子心脏病学重点实验室开放项目(KLMC-2018-02)。

摘　　要：【目的】探讨冠心病(CHD)患者冠脉斑块稳定性与血小板趋化因子水平的相关性。【方法】选取2020年6月至2022年2月中国人民解放军空军第九八六医院收治的60例CHD患者(观察组),同时根据冠脉斑块稳定性进一步分为稳定组(n=35)和不稳定组(n=25),另选取同期体检健康的60例健康志愿者为研究对象(对照组)。比较观察组与对照组血小板趋化因子16(CXCL16)、血小板趋化因子4(CXCL4)、血小板与淋巴细胞比值(PLR)、Fractalkine,比较观察组不同斑块稳定性患者的CXCL16、CXCL4、PLR、Fractalkine指标,采用受试者工作特征曲线(ROC曲线)评估CXCL16、CXCL4、PLR、Fractalkine预测CHD患者斑块不稳定的效能。【结果】观察组CXCL16、CXCL4、PLR、Fractalkine水平显著高于对照组,差异有统计学意义(P<0.05)。不稳定组CXCL16、CXCL4、PLR、Fractalkine水平高于稳定组,差异有统计学意义(P<0.05)。ROC曲线分析显示,CXCL16、CXCL4、Fractalkine、PLR预测斑块不稳定的最佳截断值分别为2.766μg/L、0.956 ng/mL、61.064 ng/mL、111.820,CXCL16曲线下面积为0.975,敏感度、特异性均较高,分别为0.920、0.943。【结论】CXCL16、CXCL4、PLR、Fractalkine水平均与CHD患者的冠脉斑块稳定性密切相关,有助于医护人员辨识CHD患者冠脉斑块的稳定性。【Objective】To investigate the relationship between the stability of coronary plaque and the level of platelet chemokines in patients with coronary heart disease(CHD).【Methods】From June 2020 to February 2022,60 CHD patients(observation group)admitted to the 986 Hospital of the Air Force of the People's Liberation Army of China were selected.At the same time,according to the stability of coronary plaque,they were further divided into stable group(n=35)and unstable group(n=25).In addition,60 healthy volunteers who were healthy during the same period were selected as the study subjects(control group).Platelet chemokine 16(CXCL16),platelet chemokine 4(CXCL4),platelet lymphocyte ratio(PLR)and Fractalkine were compared between the observation group and the control group.CXCL16,CXCL4,PLR,Fractalkine indexes of patients with different plaque stability in the observation group were compared.The receiver operating characteristic curve(ROC curve)was used to evaluate the efficacy of CXCL16,CXCL4,PLR,Fractalkine in predicting plaque instability in CHD patients.【Results】The levels of CXCL16,CXCL4,PLR and Fractalkine in the observation group were significantly higher than those in the control group(P<0.05).The levels of CXCL16,CXCL4,PLR and Fractalkine in the unstable group were higher than those in the stable group(P<0.05).ROC curve analysis shows that the best cut-off values of CXCL16,CXCL4,PLR and Fractalkine for predicting plaque instability were 2.766μg/L,0.956 ng/mL,111.820,61.064 ng/mL respectively.The area under the CXCL16 curve was 0.975,with high sensitivity and specificity,0.920 and 0.943 respectively.【Conclusion】The levels of CXCL16,CXCL4,PLR and Fractalkine are closely related to the stability of coronary plaque in CHD patients,which is helpful for doctors and nurses to identify the stability of coronary plaque in CHD patients.

关 键 词：冠心病 斑块 动脉粥样硬化 血小板因子4 

分 类 号：R541.4[医药卫生—心血管疾病]