外周血不同大小微粒水平与冠心病及冠心病血瘀证患者的相关性

Correlation between the Levels of Different Microparticles in Peripheral Blood and the Occurrence of Coronary Heart Disease and Blood Stasis Syndrome

目的 探索外周血不同大小微粒的绝对数量对冠心病及冠心病血瘀证发生的诊断价值。方法 选取冠心病患者120例,根据血瘀证辨证标准分为血瘀证组55例及非血瘀证组65例,另设健康志愿者31例作为健康组。各组受试者利用梯度离心法分离人外周血微粒,并通过0.46μm及1.0μm微球在流式细胞仪上圈定大微粒及小微粒位置,以Annexin V+(AV+)作为微粒的确定标准,采用绝对计数法统计大微粒、小微粒绝对数量。以大微粒、小微粒为自变量,以冠心病及冠心病血瘀证为因变量进行单因素分析及Logistic多因素回归分析,并绘制受试者操作特征(ROC)曲线图评估大微粒、小微粒对冠心病的诊断效能。结果 血瘀证组和非血瘀证组患者外周血大微粒、小微粒绝对数量均高于健康组(P<0.05或P<0.01);血瘀证组患者外周血大微粒、小微粒绝对数量均高于非血瘀证组(P<0.05或P<0.01)。单因素相关性分析显示,大微粒与冠心病血瘀证的发生相关(r=0.291,P=0.001);小微粒与冠心病血瘀证的发生相关(r=0.191,P=0.036)。Logistic多因素回归分析结果显示,大微粒与冠心病(回归系数:0.008,P<0.05)及冠心病血瘀证(回归系数:0.003,P<0.05)的发生相关,小微粒与冠心病(回归系数:0.006,P=0.039)及冠心病血瘀证(回归系数:0.004,P<0.05)的发生相关。ROC分析结果显示,大微粒的ROC曲线下面积(AUC)值为0.777, 95%CI:0.702~0.852, P=0.001;小微粒的AUC值为0.676, 95%CI:0.576~0.776, P=0.003。结论 外周血大微粒和小微粒的绝对数量均与冠心病及冠心病血瘀证的发生相关,其中大微粒的绝对数量对冠心病有一定的诊断价值。

Objective To explore the diagnostic value of the absolute number of peripheral blood microparticles(MP)of different sizes for coronary heart disease(CHD)and blood stasis(BS)syndrome.Methods A total of 120 CHD patients were included. Fifty-five cases were diagnosed as having BS syndrome according to the syndrome differentiation standard,while 65 cases were formed into non-BS group. Another 31 healthy volunteers were included as healthy group. Human peripheral blood particles were separated by gradient centrifugation,and the positions of large and small microparticles were delineated on the flow cytometer by 0. 46 μm and 1. 0 μm microspheres. Annexin V+(AV+)was used to determine particle. The number of large and small microparticles was presented in absolute count. Univariate analysis and Logistic multivariate regression analysis were performed,using large and small microparticles as independent variables,and CHD and CHD-blood stasis syndrome as dependent variables. The receiver operating characteristic(ROC)curves were drawn to evaluate the diagnosis performance of large and small microparticles for CHD.Results The absolute numbers of large microparticles and small microparticles in peripheral blood of CHD patients were significantly higher in BS and non-BS group than healthy group(P<0. 05 or P<0. 01),and the BS-group had higher absolute number than non-BS group(P<0. 05 or P<0. 01). Univariate analysis showed that large microparticles(r=0. 291,P=0. 001)and small microparticles(r=0. 191,P=0. 036)were associated with the occurrence of BS syndrome in CHD. Logistic multivariate regression analysis showed that large microparticles was associated with the occurrence of CHD(regression coefficient:0. 008,P<0. 05)and BS syndrome of CHD(regression coefficient:0. 003,P<0. 05);small microparticles was associated with the occurrence of CHD(regression coefficient:0. 006,P = 0. 039)and BS syndrome of CHD(regression coefficient:0. 004,P<0. 05). ROC analysis indicated that the area under the curve(AUC)value of large microparticles was 0. 777(95%CI:0. 702-0. 852,P=0. 001),and that of small microparticles was 0. 676(95%CI:0. 576-0. 776,P= 0. 003).Conclusion The levels of large microparticles and small microparticles in peripheral blood are related to the occurrence of CHD and BS syndrome of CHD,and the absolute number of large microparticles has certain diagnostic value for BS syndrome of CHD.