急性冠脉综合征患者SDF-1及CXCL16表达与预后的关系研究

Correlation between expressions of SDF-1 and CXCL16 and prognosis in patients with acute coronary syndrome

目的探讨血小板表面基质细胞衍生因子-1(S D F-1)和血浆趋化因子配体-16(CXCL16)表达与急性冠脉综合征(ACS)患者预后的相关性。方法2016年12月至2017年12月于湖北医药学院附属东风学院急诊科和心内科住院治疗并行经皮冠状动脉介入治疗(PCI)的ACS患者206例。经双色免疫荧光标记流式细胞仪检测血小板表面SDF-1的表达,采用双抗体夹心ABC-ELISA法检测患者血浆CXCL16浓度,并估计其对ACS患者PCI后主要不良心血管事件(MACE)的风险比(HR)。结果12个月随访结束时,共发生MACE 32例,其中死亡8例,再发心肌梗死10例,靶病变血运重建14例,故1年MACE发生率为15.9%。多因素COX回归分析发现,吸烟[HR(95%CI):2.28(1.48~3.50)]、SDF-1[HR(95%CI):1.28(1.16~1.42)]、肌钙蛋白I[HR(95%CI):1.17(1.09~1.25)]及高CXCL16[HR(95%CI):1.24(1.12~1.37)]是ACS患者预后不良的独立危险因素。受试者工作特征曲线(ROC)显示血小板表面SDF-1和CXCL16表达预测PCI后发生MACE的曲线下面积(AUC)分别为0.660和0.720,两者联合检测为0.795。结论CXCL16和SDF-1表达水平升高是ACS患者PCI后1年MACE发生的独立危险因素,为ACS患者预后生物标记物研究提供了新的证据。

Objective To investigate the correlation between expressions of platelet stromal-cell-derived factor-1(SDF-1)and plasma chemokine ligand 16(CXCL16)and prognosis in patients with acute coronary syndrome(ACS).Methods ACS patients undergone PCI(n=206)were chosen from Dongfeng Hospital affiliated to Hubei University of Medicine from Dec.2016 to Dec.2017.The expression of platelet SDF-1 was detected by using two-color immunofluorescence labeling flow cytometry,and concentration of plasma CXCL16 was detected by using ABC-ELISA with double antibody sandwich.The hazard ratio(HR)of major adverse cardiovascular events(MACE)was estimated in ACS patients after PCI.Results After followed up for 12 months,there were 32 cases of MACE,including 8 died cases,10 cases of recurrent myocardial infarctions and 14 cases of target lesion revascularization rate(TLR).The incidence rate of MACE was 15.9%in 1 y.The results of multi-factor COX regression analysis showed that smoking[HR(95%CI):2.28(1.48~3.50)],SDF-1[HR(95%CI):1.28(1.16~1.42)],cardiac troponin I[HR(95%CI):1.17(1.09~1.25)]and higher CXCL16[HR(95%CI):1.24(1.12~1.37)]were independent risk factors of poor prognosis in ACS patients.The ROC curve showed that AUC of SDF-1 was 0.660,AUC of CXCL16 was 0.720,and AUC of SDF-1 combined with CXCL16 was 0.795 in prediction of MACE after PCI.Conclusion The increases of CXCL16 and SDF-1 expressions are independent risk factors of MACE in ACS patients after PCI for 1 y,which provide new evidence for study on prognosis biomarkers in ACS patients.