|本期目录/Table of Contents|

[1]郝明辉 郭明 唐宇 杨婧 柳子静 闫蕊 李萍 郭金成.急性冠脉综合征患者PCI术后血浆CLEC-2水平与预后的关系[J].国际心血管病杂志,2020,02:118-122.
 HAO Minghui,GUO Ming,TANG Yu,et al.Relationship between plasma CLEC-2 level and prognosis in patients with acute coronary syndrome after PCI[J].International Journal of Cardiovascular Disease,2020,02:118-122.
点击复制

急性冠脉综合征患者PCI术后血浆CLEC-2水平与预后的关系(PDF)

《国际心血管病杂志》[ISSN:1006-6977/CN:61-1281/TN]

期数:
2020年02期
页码:
118-122
栏目:
临床研究
出版日期:
2020-03-29

文章信息/Info

Title:
Relationship between plasma CLEC-2 level and prognosis in patients with acute coronary syndrome after PCI
作者:
郝明辉 郭明 唐宇 杨婧 柳子静 闫蕊 李萍 郭金成
101100 北京,首都医科大学附属北京潞河医院心内科
Author(s):
HAO Minghui GUO Ming TANG Yu YANG Jing LIU Zijing YAN Rui LI Ping GUO Jincheng
Department of Cardiology, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, China
关键词:
急性冠脉综合征 经皮冠状动脉介入术 C型凝集素样受体2 预后
Keywords:
Acute coronary syndrome Percutaneous coronary intervention C-type lectin-like receptor 2 Prognosis
分类号:
-
DOI:
10.3969/j.issn.1673-6583.2020.02.013
文献标识码:
-
摘要:
目的:探讨急性冠脉综合征(ACS)患者经皮冠状动脉介入术(PCI)后血浆C型凝集素样受体2(CLEC-2)水平与预后的关系。方法:前瞻性选取2016年1月至2017年6月在首都医科大学附属北京潞河医院就诊的150例ACS患者作为研究对象。采用受试者工作特征(ROC)曲线分析CLEC-2评估ACS患者预后的最佳截断点。根据CLEC-2评价ACS患者预后的最佳截断点将患者分为高CLEC-2组(n=32)和低CLEC-2组(n=118)。采用酶联免疫吸附法检测ACS患者血浆中CLEC-2水平,并通过Cox回归分析其与ACS患者预后的关系。结果:血浆CLEC-2评价ACS患者预后的ROC曲线下面积(AUC)为0.885(95%CI:0.812~0.958),最大约登指数为0.643,最佳截断点为158.63 pg/mL,敏感度为71.87%,特异度为92.37%。两组在年龄、ACS家族史、CLEC-2水平及左室射血分数(LVEF)等方面的差异有统计学意义(P均<0.05)。高CLEC-2组主要不良血管事件(MACE)的发生率明显高于低CLEC-2组(71.88%对7.63%,P<0.001),平均生存时间明显低于低CLEC-2组[17.25(15.40~19.10)个月对23.34(22.91~23.77)个月,P<0.001]。Cox单因素及多因素分析结果显示慢性阻塞性肺疾病及CLEC-2水平与ACS患者MACE发生密切相关。结论:高CLEC-2是ACS患者PCI后发生MACE的独立危险因素。
Abstract:
Objective:To investigate the relationship between plasma C-type lectin-like receptor 2(CLEC-2)level and prognosis in patients with acute coronary syndrome(ACS)following percutaneous coronary intervention(PCI).Methods:A total of 150 patients with ACS who were admitted to Beijing Luhe Hospital affiliated to Capital Medical University from January 2016 to June 2017 were prospectively included. The receiver operating characteristic(ROC)curve was used to determine the best cutoff point for CLEC-2 to evaluate the prognosis in patients with ACS. The patients were divided into high CLEC-2 group(n=32)and low CLEC-2 group(n=118), according to the best cutoff point value of CLEC-2. The plasma CLEC-2 level was detected by enzyme-linked immunosorbent assay. Cox regression was used to analysis the relationship between CLEC-2 level and the prognosis of patients with ACS.Results:The area under ROC curve(AUC)was 0.885(95%CI 0.812-0.958).The Youden index was the largest(0.390)when CLEC-2 level was 158.63 pg/mL, and the sensitivity was 71.87%, and the specificity was 92.37%. There were significant differences in age, ACS family history, CLEC-2 level, and left ventricular ejection fraction(LVEF)between the two groups(all P<0.05). The incidence of major adverse cardiovascular events(MACE)in the high CLEC-2 group was higher than that in the low CLEC-2 group(71.88% vs. 7.63%, P<0.001), and the survival time of the high CLEC-2 group was lower than that of the low CLEC-2 group(17.25(15.40, 19.10)months vs. 23.34(22.91, 23.77)months, P<0.001). Cox univariate and multivariate analysis showed that chronic obstructive pulmonary disease and CLEC-2 levels were closely associated with MACE in patients with ACS.Conclusions:High CLEC-2 is an independent risk factor for MACE after PCI in patients with ACS.

参考文献/References

[ 1 ] 刘胜聪, 易铁慈, 翁浩宇, 等. 基线血浆髓过氧化物酶水平对急性冠状动脉综合征患者预后的影响[J]. 中华心血管病杂志, 2018, 46(4):284-291.
[ 2 ] Jiang J, Ji HY, Xie WM, et al. Could platelet-to-lymphocyte ratio be a predictor for contrast-induced nephropathy in patients with acute coronary syndrome? A systematic review and meta-analysis[J]. Medicine(Baltimore), 2019, 98(32):e16801.
[ 3 ] 许连军, 宋莹, 许晶晶, 等. 直接胆红素对行介入治疗的急性冠状动脉综合征患者远期预后的影响[J]. 中华心血管病杂志, 2018, 46(5):352-358.
[ 4 ] Skarpengland T, Skjelland M, Kong XY, et al. Increased levels of lectin-like oxidized low-density lipoprotein receptor-1 in ischemic stroke and transient ischemic attack[J]. J Am Heart Assoc, 2018, 7(2):1-10.
[ 5 ] 中国医师协会急诊医师分会, 中华医学会心血管病学分会, 中华医学会检验医学分会. 急性冠脉综合征急诊快速诊疗指南[J]. 中华急诊医学杂志, 2016, 25(4):397-404.
[ 6 ] 申文彬, 白静, 杨霞, 等. 血小板高反应性对冠状动脉钙化患者介入术后发生主要不良心血管事件的研究[J]. 中华老年心脑血管病杂志, 2016, 18(2):153-157.
[ 7 ] Reichlin T, Cullen L, Parsonage WA, et al. Two-hour algorithm for triage toward rule-out and rule-in of acute myocardial infarction using high-sensitivity cardiac troponin T[J]. Am J Med, 2015, 128(4):369-379..
[ 8 ] Niccoli G, Scalone G, Lerman A, et al. Coronary microvascular obstruction in acute myocardial infarction[J]. Eur Heart J, 2016, 37(13):1024-1033.
[ 9 ] Yao K, Wang Y, Xu D, et al. Effect of combined testing of ceramides with high-sensitive troponin T on the detection of acute coronary syndrome in patients with chest pain in China: a prospective observational study[J]. BMJ Open, 2019, 9(7):e028211.
[10] 李瑞娜, 李红, 李博, 等. 血小板分布宽度与急性心肌梗死患者严重程度及预后的相关性分析[J]. 中国急救医学, 2018, 38(5):399-402.
[11] Martyanov AA, Kaneva VN, Panteleev MA, et al. CLEC-2 induced signalling in blood platelets[J]. Biomed Khim, 2018, 64(5):387-396.
[12] Tsukiji N, Osada M, Sasaki T, et al. Cobalt hematoporphyrin inhibits CLEC-2-podoplanin interaction, tumor metastasis, and arterial/venous thrombosis in mice[J]. Blood Adv, 2018, 2(17):2214-2225.
[13] Tsukiji N, Inoue O, Morimoto M, et al. Platelets play an essential role in murine lung development through Clec-2/podoplanin interaction[J]. Blood, 2018, 132(11):1167-1179.
[14] Inoue O, Hokamura K, Shirai T, et al. Vascular smooth muscle cells stimulate platelets and facilitate thrombus formation through platelet CLEC-2: implications in atherothrombosis[J]. PLoS One, 2015, 10(9):e0139357.
[15] Hatakeyama K, Kaneko MK, Kato Y, et al. Podoplanin expression in advanced atherosclerotic lesions of human aortas[J]. Thromb Res, 2012, 129(4):e70-e76.
[16] Navarro-Núñez L, Langan SA, Nash GB, et al. The physiological and pathophysiological roles of platelet CLEC-2[J]. Thromb Haemost, 2013, 109(6):991-998.
[17] 费敏. 可溶性凝集素样受体2在冠状动脉粥样硬化性心脏病中的诊断作用及变化机制的研究[D]. 苏州:苏州大学, 2016.
[18] Kerrigan AM, Dennehy KM, Mourão-Sá D, et al. CLEC-2 is a phagocytic activation receptor expressed on murine peripheral blood neutrophils[J]. J Immunol, 2009, 182(7):4150-4157.
[19] Chaipan C, Soilleux EJ, Simpson P, et al. DC-SIGN and CLEC-2 mediate human immunodeficiency virus type 1 capture by platelets[J]. J Virol, 2006, 80(18):8951-8960.
[20] Fuller GL, Williams JA, Tomlinson MG, et al. The C-type lectin receptors CLEC-2 and Dectin-1, but not DC-SIGN, signal via a novel YXXL-dependent signaling cascade[J]. J Biol Chem, 2007, 282(17):12397-12409.
[21] Bender M, May F, Lorenz V, et al. Combined in vivo depletion of glycoprotein Ⅵ and C-type lectin-like receptor 2 severely compromises hemostasis and abrogates arterial thrombosis in mice[J]. Arterioscler Thromb Vasc Biol, 2013, 33(5):926-934.

备注/Memo

备注/Memo:
基金项目:北京市卫计委首发专项(2018-2-7082)
作者单位:101100 北京,首都医科大学附属北京潞河医院心内科
通信作者:郝明辉,E-mail:haominghui828@sina.com
更新日期/Last Update: 2020-03-30