外周血淋巴细胞亚群与颈动脉粥样硬化发生的关联性分析

Association analysis on peripheral blood lymphocyte subsets and occurrence of carotid atherosclerosis

目的:分析外周血淋巴细胞亚群与颈动脉粥样硬化(CAS)发生的关联性,探讨CAS发生的危险因素,为CAS的风险预测和早期干预提供依据。方法:按照纳入和排除标准选取419名体检者作为研究对象,行颈动脉超声检查和T淋巴细胞、B淋巴细胞及自然杀伤(NK)细胞亚群检测,根据颈动脉内中膜厚度(IMT)将研究对象分为颈动脉正常组(n=166)和CAS组(n=253),收集2组研究对象的基本资料和实验室检查指标,包括年龄、性别、血压、既往病史、吸烟史、用药史、血脂及T淋巴细胞、B淋巴细胞和NK细胞亚群百分率等,采用Logistic回归分析研究对象CAS发生的危险因素。结果:单因素分析,与颈动脉正常组比较,CAS组患者年龄、高血压患病率、糖尿病患病率和吸烟率均升高(P<0.05),外周血中CD4+T淋巴细胞百分率、CD4+T淋巴细胞计数、CD4+/CD8+比值、CD16+CD56+NK细胞计数及低密度脂蛋白胆固醇(LDL-c)水平升高(P<0.05), CD8+T淋巴细胞百分率降低(P<0.05)。多因素Logistic回归分析,年龄(OR=1.112,95%CI:1.083~1.142, P<0.001)、吸烟(OR=1.997, 95%CI:1.192~3.346, P=0.009)、LDL-c (OR=1.427, 95%CI:1.017~2.001, P=0.039)和CD4+T淋巴细胞百分率(OR=1.044,95%CI:1.002~1.087,P=0.039)是CAS发生的独立危险因素。结论:CD4+T淋巴细胞百分率与CAS发生有关联,是CAS的危险预测因素。

Objective:To analyze the association between the peripheral blood lymphocyte subsets and the occurrence of carotid atherosclerosis(CAS)and discuss the risk factors of CAS,and to provide the basis for risk prediction and early intervention of CAS.Methods:A total of 419 subjects were selected according to the inclusion and exclusion criteria.All the subjects underwent carotid ultrasonography,and the detection of T lymphocyte,B lymphocyte,and natural killer(NK)cell subsets were performed.According to the carotid artery intima-media thickness(IMT),the subjects were divided into normal carotid artery group(n=166)and CAS group(n=253).The basic data and laboratory inspection indexes of the subjects in two groups were collected,including age,gender,blood pressure,medical history,smoking history,medication history,blood lipids,and percentages of T lymphocyte,B lymphocyte,and NK cell subsets.The risk factors for the occurrence of CAS of the subjects were analyzed using Logistic regression analysis.Results:The univariate analysis results showed that compared with normal carotid artery group,the age,morbidity rate of hypertension,morbidity rate of diabetes,and smoking rate of the subjects in CAS group were increased(P<0.05),and the percentages of CD4+T lymphocytes,CD4+T lymphocyte count,CD4+/CD8+ratio,CD16+CD56+NK cell count,and low-density lipoprotein cholesterol(LDL-c)level in peripheral blood were increased(P<0.05),while the percentage of CD8+T lymphocyte was decreased(P<0.05).The multivariable Logistic regression analysis results showed that age(OR=1.112,95%CI:1.083-1.142,P<0.001),smoking(OR=1.997,95%CI:1.192-3.346,P=0.009),LDL-c(OR=1.427,95%CI:1.017-2.001,P=0.039),and percentage of CD4+T lymphocyte(OR=1.044,95%CI:1.002-1.087,P=0.039)were the independent risk factors for the occurrence of CAS.Conclusion:The percentage of CD4+T lymphocyte is associated with the occurrence of CAS and it is a predictive risk factor for CAS.