趋化因子配体17联合超敏C-反应蛋白对不稳定型心绞痛的预测价值
摘要
目的探讨趋化因子配体17(CXCL17)联合超敏C反应蛋白(hs-CRP)对不稳定型心绞痛(UA的预测价值。方法选取2017年4月到2018年7月在该院住院的冠状动脉粥样硬化性心脏病患者共97例,其中稳定型心绞痛(SA)患者50例(SA组),UA患者47例(UA组),另收集在该院行冠状动脉造影正常患者20例作为对照组。收集各组患者血清用酶联免疫吸附试验(ELISA)法测定CXCL17水平,全自动生化仪测定血脂、hs-CRP。比较3组患者CXCL17及临床生化指标差异。结果与SA组及对照组比较,CXCL17在UA组血清中表达明显上调(P<0.05),而SA组和对照组比较差异无统计学意义(P>0.05);UA组血清hs-CRP均高于SA组(P<0.05),Logistic回归分析示CXCL17、hs-CRP是UA的独立危险因素,将CXCL17、hs-CRP联合作为危险因子预测UA的敏感度为93.6%、特异度为80.0%、AUC为0.929,优于CXCL17(敏感度为74.5%、特异度为80.0%、AUC为0.835)和hs-CRP(敏感度为76.6%、特异度为88.0%、AUC为0.901)。结论CXCL17联合hs-CRP对UA具有较高的预测价值。
引文
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[3]SAGER H B,NAHRENDORF M.Inflammation:a trigger for acute coronary syndrome[J].Q J Nucl Med Mol Imaging,2016,60(3):185-193.
[4]OPSTAD T B,ARNESEN H,PETTERSEN A A.Combined elevated levels of the proinflammatory cytokines IL-18and IL-12are associated with clinical events in patients with coronary artery disease:an observational study[J].Metab Syndr Relat Disord,2016,14(5):242-248.
[5]RIDKER P M,EVERETT B M,THUREN T,et al.Antiinflammatory therapy with canakinumab for atherosclerotic disease[J].N Engl J Med,2017,377(12):1119-1131.
[6]ZHONG Y,YE F,YOU W,et al.Correlation between serum inflammatory cytokine levels and fibrous cap thickness of fibrofatty plaque in coronary culprit lesions[J].Zhonghua Xin Xue Guan Bing Za Zhi,2017,45(7):566-571.
[7]SAFA A,RASHIDINEJAD H R,KHALILI M,et al.Higher circulating levels of chemokines CXCL10,CCL20and CCL22in patients with ischemic heart disease[J].Cytokine,2016,83:147-157.
[8]PISABARRO M T,LEUNG B,KWONG M,et al.Cutting edge:Novel human dendritic cell-and monocyte-attracting chemokine-like protein identified by fold recognition methods[J].J Immunol,2006,176(4):2069-2073.
[9]OHLSSON L,HAMMARSTRM M L,LINDMARK G,et al.Ectopic expression of the chemokine CXCL17in colon cancer cells[J].Br J Cancer,2016,114(6):697-703.
[10]RONKAINEN V P,TUOMAINEN T,HUUSKO J A,et al.Hypoxia-inducible factor 1-induced G protein-coupled receptor 35expression is an early marker of progressive cardiac remodelling[J].Cardiovasc Res,2014,101(1):69-77.
[11]LEE W Y,WANG C J,LIN T Y,et al.CXCL17,an orphan chemokine,acts as a novel angiogenic and anti-inflammatory factor[J].Am J Physiol Endocrinol Metab,2013,304(1):E32-40.
[12]BURKHARDT A M,MARAVILLAS-MONTERO J L,CARNEVALE C D,et al.CXCL17is a major chemotactic factor for lung macrophages[J].J Immunol,2014,193(3):1468-1474.
[13]ZAKYNTHINOS E,PAPPA N.Inflammatory biomarkers in coronary artery disease[J].J Cardiol,2009,53(3):317-333.
[14]REYNOSO-VILLALPANDO G L,PADILLA-GUTIRREZJ R,VALDEZ-HARO A,et al.Relationship between C-Reactive protein serum concentration and the 1846 C>T(rs1205)polymorphism in patients with acute coronary syndrome from western Mexico[J].Genet Test Mol Biomarkers,2017,21(5):334-340.
[15]SEYEDIAN S M,AHMADI F,DABAGH R,et al.Relationship between high-sensitivity C-reactive protein serum levels and the severity of coronary artery stenosis in patients with coronary artery disease[J].ARYA Atheroscler,2016,12(5):231-237.
[16]BRITO V,ALCARAZ A,AUGUSTOVSKI F A,et al.High sensitivity C protein as an Independent risk factor in people with and without history of cardiovascular disease[J].Arch Cardiol Mex,2015,85(2):124-135.