急性ST段抬高性心肌梗死患者外周血单核细胞亚群变化及其临床意义

发布时间：2018-05-09 08:03

本文选题：急性心肌梗死 + 单核细胞　；参考：《中国现代医学杂志》2014年34期

【摘要】：目的探讨急性ST段抬高性心肌梗死(STEMI)患者外周血单核细胞亚群变化及其与心肌梗死继发性炎症反应、心肌缺血损伤范围和心室重构关系。方法对36例STEMI患者心肌梗死病程第5天采血,流式细胞术分析外周血单核细胞及其亚群,检测外周血白细胞计数(WBC)、超敏C-反应蛋白(hs-CRP);超声检测左室舒张末内径(LVD)、左室射血分数(LVEF);记录病程前3天心电图ST段弓背上抬导联最大数目(NSTE)及病程中肌酸激酶同工酶(CK-MB)峰值水平。取健康成人30例作为正常对照组。结果与正常对照组比较,STEMI患者单核细胞数增多(P0.01),CD14++CD16-单核细胞亚群比例降低(P0.01),CD14++CD16+,CD14+CD16++单核细胞亚群比例升高(P0.01);CD14++CD16-单核细胞亚群比例与外周血WBC、hs-CRP水平、NSTE、CK-MB峰值水平、LVD呈正相关,与LVEF呈负相关(均P0.01);CD14+CD16++单核细胞亚群比例与外周血WBC、hs CRP水平、NSTE、CK-MB峰值水平、LVD呈负相关,与LVEF呈正相关(均P0.05);与常规药物治疗比较,接受急诊冠脉再灌注(PCI)治疗STEMI患者CD14++CD16-单核细胞比亚群例降低,CD14+CD16++单核细胞亚群比例升高(均P0.01)。结论 STEMI患者第5天单核细胞亚群比例变化与STEMI患者炎症反应、缺血损伤范围及心室重构相关。
[Abstract]:Objective to investigate the changes of monocyte subsets in peripheral blood of patients with acute ST-segment elevation myocardial infarction (STEMI) and their relationship with secondary inflammation, myocardial ischemic injury and ventricular remodeling. Methods Blood samples were collected from 36 patients with STEMI on the 5th day after myocardial infarction. Peripheral blood monocytes and their subsets were analyzed by flow cytometry. Detection of white blood cell count (WBCU), hypersensitive C-reactive protein (hs-CRPN), left ventricular end-diastolic diameter (LVDV), left ventricular ejection fraction (LVVEFV), maximum number of St segment upper-lift leads (NSTE) and creatine kinase (CK) in the course of the disease were recorded 3 days before the course of the disease. The peak level of CK-MBs. 30 healthy adults were taken as the normal control group. Results compared with the control group, the number of monocytes increased in patients with STEMI and the proportion of CD16- monocyte subsets of CD14 CD14 was decreased in patients with STEMI. The proportion of monocyte subsets of CD14 CD16 and CD14 CD16 increased in patients with P0.01Mi and the ratio of CD16- monocyte subsets in peripheral blood WBChs-CRP and the peak value of CK-MB in peripheral blood WBChs-CRP. The level of LVD was positively correlated, The ratio of CD14 CD16 monocyte subsets was negatively correlated with LVEF, and positively correlated with LVEF (all P 0.05), and was negatively correlated with the level of CRP in peripheral blood (P < 0.01), and positively correlated with LVEF (P < 0.05), compared with that of routine drug therapy, and the positive correlation was found between the ratio of CD14 monocyte subsets and the peak level of CK-MB in peripheral blood (P < 0.05). The percentage of CD16- monocytes in STEMI patients treated with emergency coronary reperfusion was significantly lower than that in subsets (P < 0.01). Conclusion the changes of monocyte subsets in patients with STEMI on day 5 are related to inflammation, ischemic injury and ventricular remodeling in patients with STEMI.
【作者单位】：中南大学湘雅医院心内科;
【分类号】：R542.22

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