基线外周血单核细胞水平对冠心病患者PCI术后长期死亡风险的影响研究

Influence of baseline peripheral blood mononuclear cell level on long-term death risk in patients with coronary heart disease after PCI

目的 探究冠状动脉粥样硬化性心脏病(冠心病)患者经皮冠状动脉介入治疗(PCI)术后基线外周血循环单核细胞(MO)水平对患者长期死亡风险的影响。方法 选取2017年6月至2019年6月于北京潞河医院心内科收治的110例冠心病PCI术后患者进行随访观察。根据患者基线外周血MO水平分为A组(MO<0.56×10^(9)/L)和B组(MO≥0.56×10^(9)/L),两组各55例,随访时间(35.91±2.61)个月。观察并分析影响患者长期死亡风险的因素,观察指标包括:心脏死亡及不良心脑血管事件。结果 两组基线资料[性别、吸烟、饮酒、年龄、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、肌酐(Cr)、尿酸(UA)、血清载脂蛋白Al(ApoAl)和载脂蛋白B(ApoB)]比较,差异均有统计学意义(P>0.05)。组内比较:在随访3个月、6个月、1年、3年的不同时间节点,A组心脏死亡发生率比较差异无统计学意义(P>0.05),其不良心脑血管事件发生率比较差异有统计学意义(P<0.05);B组的心脏死亡发生率、不良心脑血管事件发生率对比差异均有统计学意义(P<0.05)。组间比较:两组在随访3个月、6个月心脏死亡发生率比较差异无统计学意义(P>0.05),在随访1年、3年心脏死亡发生率比较差异有统计学意义(P<0.05);两组在随访3个月、6个月、1年、3年不良心脑血管事件发生率比较差异均有统计学意义(P<0.05)。同时随着随访时间的延长,两组患者基线外周血MO水平差异越大;两组患者3年内心脑血管事件发生率差异显著(P<0.05)。结论 冠心病患者PCI术后随访发现,基线外周血MO水平是最关键的独立预测指标,可预测患者PCI术后的长期死亡风险。

Objective To discuss the influence of level of baseline peripheral blood mononuclear cells(MO) on long-term death risk in patients with coronary heart disease(CHD) after percutaneous coronary intervention(PCI). Methods CHD patients undergone PCI(n=110) were chosen from Department of Cardiology in Beijing Luhe Hospital from June 2017 to June 2019. All patients were divided, according to baseline peripheral blood MO level, into group A(MO<0.56×10^(9)/L) and group B(MO≥0.56×10^(9)/L, each n=55), and followed up for(35.91±2.61) months. The factors affecting long-term death risk were observed and analyzed, and the observation indexes included cardiac death and major adverse cardiovascular and cerebrovascular events(MACCE). Results The comparison in baseline materials [gender, smoking, drinking, age, total cholesterol(TC), high-density lipoproteincholesterol(HDL-C), low-density lipoprotein-cholesterol(LDL-C), creatinine(Cr), uric acid(UA), apolipoprotein A1(ApoAl) and apolipoprotein(ApoB)] showed that differences had statistical significance(P>0.05) between 2groups. The comparison within group showed that the differences in incidence rate of cardiac death had no statistical significance(P>0.05), and the differences in incidence rate of MACCE had statistical significance(P<0.05) in group A at the time points of 3 months, 6 months, 1 y and 3 y, and the differences in incidence rate of cardiac death and incidence rate of MACCE had statistical significance(P<0.05) in group B at above-mentioned time points.The comparison between groups showed that the difference in incidence rate of cardiac death had no statistical significance after follow-up for 3 months and 6 months(P<0.05), and difference in incidence rate of MACCE had statistical significance after follow-up for 3 months, 6 months, 1 y and 3 y(P<0.05). With the extension of followup time, the difference in baseline peripheral blood MO level became larger and larger between 2 groups. The difference in incidence rate of MACCE was significant between 2 groups within 3 y. Conclusion The level of baseline peripheral blood MO is a key independent predictive index found through followed-up, which can predict long-term death risk in CHD patients after PCI.