M1型巨噬细胞水平与冠心病疾病严重程度及预后的相关性分析

Correlation between M1 Macrophage Level and Severity and Prognosis of Coronary Heart Disease

目的:探讨M1型巨噬细胞水平与冠心病疾病严重程度及预后的相关性。方法:选取佳木斯市中心医院2018年12月-2019年12月收治的65例冠心病患者作为研究对象,依照患者的病情严重程度,将其分为不稳定型心绞痛组(n=21)、急性心肌梗死组(n=18)和稳定型心绞痛组(n=26),另取30例健康者作为对照组,对比四组M1型巨噬细胞比例、可溶性超敏C反应蛋白(hs-CRP)、转化生长因子-β1(TGF-β1)以及肿瘤坏死因子-α(TNF-α)的表达水平,并分析各项指标与冠心病严重程度的相关性。对所有患者随访1年,将发生心血管不良事件的21例患者设为预后不良组,将无心血管不良事件的44例患者设为预后良好组,对比两组患者临床各指标,并分析M1型巨噬细胞水平对冠心病的预后预测价值。结果:四组M1型巨噬细胞比例、hs-CRP、TGF-β1以及TNF-α的表达水平对比,差异均有统计学意义(P<0.05);Spearman相关性分析结果显示,M1型巨噬细胞、hs-CRP、TNF-α与冠心病严重程度均呈正相关(P<0.05),TGF-β1与冠心病严重程度呈负相关(P<0.05);预后良好组与预后不良组患者性别、体质量指数(BMI)、TGF-β1和TNF-α表达水平对比,差异均无统计学意义(P>0.05),预后良好组与预后不良组患者年龄、吸烟、合并2型糖尿病情况、M1型巨噬细胞比例以及hs-CRP水平对比,差异均有统计学意义(P<0.05);M1型巨噬细胞比例≥63.04%为冠心病的预后不良独立因素(P<0.05)。结论:M1型巨噬细胞与冠心病的严重程度具有相关性,且年龄、吸烟、合并2型糖尿病情况、M1型巨噬细胞比例以及hs-CRP水平均为冠心病预后不良的相关因素,M1型巨噬细胞比例≥63.04%对冠心病的预后具有独立预测价值,为冠心病不良心血管事件发生的独立预测因子。

Objective:To investigate the correlation between M1 macrophage level and severity and prognosis of coronary heart disease.Method:A total of 65 patients with coronary heart disease in Jiamusi Central Hospital from December 2018 to December 2019 were selected as the research objects.According to the severity of the disease,they were divided into unstable angina pectoris group (n=21),acute myocardial infarction group (n=18)and stable angina pectoris group (n=26).Another 30 healthy people were selected as the control group.The proportion of M1 macrophages,hs-CRP,TGF-β1 and TNF-α in the four groups were compared.The correlation between each index and the severity of coronary heart disease was analyzed.All patients were followed up for 1 year,21 patients with cardiovascular adverse events were selected as poor prognosis group,and 44 patients without cardiovascular adverse events were selected as good prognosis group.The clinical indexes of the two groups were compared,and the predictive value of M1 macrophage level for coronary heart disease was analyzed.Result:There were significant differences in the proportion of M1 macrophages,hs-CRP,TGF-β1 and TNF-α in the four groups (P<0.05).Spearman correlation analysis showed that M1 macrophages,hs-CRP,TNF-α were positively correlated with the severity of coronary heart disease (P<0.05),TGF-β1 was negatively correlated with the severity of coronary heart disease (P<0.05);there were no significant differences in gender,body mass index (BMI),TGF-β1 and TNF-α in patients between the good prognosis group and the poor prognosis group (P>0.05).There were significant differences in age,smoking,type 2 diabetes mellitus,the proportion of M1 macrophages and hs-CRP level between the good prognosis group and the poor prognosis group (P<0.05).The proportion of M1 macrophages ≥63.04% was an independent factor for poor prognosis of coronary heart disease (P<0.05).Conclusion:M1 macrophages are related to the severity of coronary heart disease.Age,smoking,type 2 diabetes,the proportion of M1 macrophages and the level of hs-CRP are all related factors for the poor prognosis of coronary heart disease.The proportion of M1 macrophages ≥63.04% has independent predictive value for the prognosis of coronary heart disease and is an independent predictor of adverse cardiovascular events of coronary heart disease.