可溶性CD40L对轻中度冠状动脉狭窄者临床预后的影响  

The impact of soluble CD40L on the clinical prognosis in patients with mild to moderate coronary artery stenosis

作　　者：杨兴胜 顾菲菲 吕树铮[3] YANG Xingsheng;GU Feifei;LV Shuzheng(Department of Cardiology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100071,China)

机构地区：[1]首都医科大学附属北京天坛医院心内科,100071 [2]首都医科大学附属北京天坛医院应急管理部应急总医院心内科,100071 [3]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心内科

出　　处：《心肺血管病杂志》2024年第7期700-705,共6页Journal of Cardiovascular and Pulmonary Diseases

基　　金：北京市科委重大科技项目(D0906006000091)。

摘　　要：目的:探讨血浆可溶性CD40L(soluble CD40L,sCD40L)浓度对轻中度冠状动脉狭窄患者临床预后的影响。方法:在11个三级医疗中心收集冠状动脉造影轻中度狭窄且未介入治疗的患者,检测患者入院时血浆sCD40L浓度,预设临床终点(包括心源性死亡、非致死性心梗、靶病变血运重建和因心绞痛加重再入院)对患者进行随访。结果:共964例患者纳入研究,中位数随访时间18个月后193例出现预设临床事件,sCD40L在有事件组较无事件组显著偏高[116.9(55.2,221.6)vs.97.1(42.7,185.5),P=0.011],多元Cox回归分析显示,sCD40L是临床预后的独立危险因素(HR=1.001,95%CI:1.000~1.002,P=0.035),根据sCD40L浓度将患者分为低、中和高sCD40L组,生存分析发现高sCD40L组较低sCD40L组临床事件发生率显著升高(χ^(2)=5.024,P=0.025)。结论:血浆sCD40L浓度与轻中度冠状动脉狭窄患者的临床预后显著相关,从而有助于对该类患者进行危险分层。Objective:To explore the impact of soluble CD40L(sCD40L)on the clinical prognosis in patients with mild to moderate coronary artery stenosis.Methods:Patients with mild to moderate coronary artery stenosis without intervention treatment were collected from 11 tertiary medical centers.Plasma sCD40L concentration at admission was measured.Patients were followed up with predetermined clinical endpoints(including cardiac death,non fatal myocardial infarction,target lesion revascularization and readmission due to worsening angina).Results:A total of 964 patients were included in the study.After a median follow-up of 18 months,193 patients experienced preset clinical events.The sCD40L concentration was significantly higher in group with events than the group without[116.9(55.2,221.6)vs.97.1(42.7,185.5),P=0.011].Multivariate Cox regression analysis showed that sCD40L was an independent risk factor for clinical prognosis(HR=1.001,95%CI:1.000-1.002,P=0.035).Patients were divided into low,medium,and high sCD40L groups based on sCD40L concentration.Survival analysis showed that the high sCD40L group had a significantly higher incidence of clinical events compared to the low sCD40L group(χ^(2)=5.024,P=0.025).Conclusions:The plasma sCD40L concentration is significantly correlated with the clinical prognosis in patients with mild to moderate coronary artery stenosis,thus help with risk stratification in such patients.

关 键 词：可溶性CD40L 临床预后 冠状动脉造影 轻中度狭窄 

分 类 号：R54[医药卫生—心血管疾病]