| 张 驰,王 珣,管倩倩,赵生娣,王丽岳.经阿托伐他汀治疗的急性冠脉综合征患者CD4+T、CD4+CD28+T水平变化及与预后的关系[J].,2019,19(22):4312-4315 |
| 经阿托伐他汀治疗的急性冠脉综合征患者CD4+T、CD4+CD28+T水平变化及与预后的关系 |
| Changes of CD4+T and CD4+CD28+T levels in Patients with Acute Coronary Syndrome Treated with Atorvastatin and Their Relationship with Prognosis |
| 投稿时间：2019-04-08 修订日期：2019-05-03 |
| DOI：10.13241/j.cnki.pmb.2019.22.024 |
| 中文关键词: 阿托伐他汀 急性冠脉综合征 CD4+T CD4+CD28+T 终点事件 |
| 英文关键词: Atorvastatin Acute coronary syndrome CD4+T CD4+CD28+T Endpoint events |
| 基金项目:湖北省卫计委联合基金面上项目（WJ2018H0107）；武汉市卫生局临床医学科研项目（WX12D01） |
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| 中文摘要: |
| 摘要 目的：探讨经阿托伐他汀治疗的急性冠脉综合征（ACS）的CD4+T、CD4+CD28+T水平变化及与预后的关系。方法：选择128例ACS患者，随机分为对照组（64例）和观察组两组（64例），其中对照组患者给予常规治疗，观察组患者在上述基础上外加阿托伐他汀治疗。比较两组患者的细胞因子、CD4+T及CD4+CD28+T水平变化，随访6个月，观察两组患者预后终点事件发生情况。并将观察组患者根据预后是否并发终点事件，将其分为预后良组（未并发终点事件）和预后不良组（并发终点事件）两组，分析不同预后ACS患者CD4+T、CD4+CD28+ T水平变化及与预后发生终点事件的相关性。结果：治疗后两组的高敏C反应蛋白（hs-CRP）、干扰素-γ（IFN-γ）水平均明显降低，白细胞介素-10（IL-10）、转化生长因子β1（TGF-β1）水平均明显升高，且观察组改善更为明显，差异均有统计学意义（P<0.05）。两组患者治疗后CD4+T明显升高，CD8+T、CD4+CD28+T明显降低，且观察组上述指标改善更为明显，差异均有统计学意义（P<0.05）。随访6月中，对照组患者预后有23例终点事件发生，观察组患者预后有26例终点事件发生，差异无统计学意义（P＞0.05）。与预后良好组相比，预后不良组患者的CD4+T降低，CD4+CD28+T升高，差异均有统计学意义（P<0.05）。经阿托伐他汀治疗的ACS患者预后发生终点事件与CD4+T水平呈现负相关（r=-0.682，P=0.000），与CD4+CD28+ T水平呈现正相关（r=0.733，P=0.000）。结论：经阿托伐他汀治疗的ACS患者预后发生终点事件与CD4+T水平呈现负相关，与CD4+CD28+ T水平呈现正相关，可为临床ACS患者预后的预测提供参考。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the changes of CD4+T, CD4+CD28+T levels and prognosis in patients with acute coronary syndrome treated with atorvastatin. Methods: 128 patients with ACS were randomly divided into the control group (64 cases) and the observation group (64 cases). The control group received routine treatment, and the observation group received atorvastatin on the above basis. The changes of cytokines, CD4+T and CD4+CD28+T levels were compared between the two groups. The follow-up was observed for 6 months. The prognosis endpoints of the two groups were observed. Patients in the observation group were divided into good prognosis group (no concurrent end point event) and poor prognosis group (concurrent end point event) according to whether the prognosis was concurrent with the end point event. The changes of CD4+T and CD4+CD28+T levels in patients of ACS with different prognosis were analyzed and and their correlation with prognostic endpoint events. Results: After treatment, the levels of high-sensitivity C-reactive protein (hs-CRP) and interferon-γ(IFN-γ) in the two groups were significantly decreased, while the levels of interleukin-10 (IL-10) and transforming growth factor-β1(TGF-β1) were significantly increased, and the improvement in the observation group was more obvious, the difference was statistically significant (P<0.05). After treatment, CD4+T increased significantly, CD8+T and CD4+CD28+T decreased significantly in both groups, and the above indexes improved more significantly in the observation group, the difference was statistically significant (P<0.05). During the follow-up period of 6 months, there were 23 endpoint events in the control group and 26 endpoint events in the observation group, with no significant difference (P>0.05). Compared with the good prognosis group, the CD4+T decreased and the CD4+CD28+T increased in poor prognosis group (P<0.05). The prognostic endpoint events of ACS patients treated with atorvastatin were negatively correlated with CD4+T level (r=-0.682, P=0.000), and positively correlated with CD4+CD28+T level (r=0.733, P=0.000). Conclusion: The prognosis endpoint of ACS patients treated with atorvastatin was negatively correlated with CD4+T level and positively correlated with CD4+CD28+T level, which could provide a reference for predicting the prognosis of patients with ACS. |
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