血浆中趋化因子CCL2水平与ST抬高型心肌梗死患者预后相关性研究

目的探讨ST抬高型心肌梗死(STEMI)患者血浆中趋化因子CCL2水平与1年内发生主要心脑血管不良事件(MACCE)的相关性。方法选择2014年6月至2015年10月沈阳军区总医院冠心病监护病房收治的420例STEMI患者为研究对象。详细采集患者临床资料,采用酶联免疫吸附检测血浆中CCL2浓度。对患者进行1年的临床随访,终点为MACCE。确定入选患者血浆中CCL2的中位数浓度,并将患者分为A、B两组。利用Kaplan-Meier法比较随访1年时两组MACCE的发生率。利用Cox回归模型分析血浆中CCL2水平与患者1年内发生MACCE的相关性。结果发生MACCE(包括全因死亡、心衰、脑梗死、再发心梗)的患者,血浆中CCL2浓度明显高于未发生MACCE的患者。患者血浆中CCL2的中位数浓度为179.89 pg/ml,A组CCL2浓度≤179.89 pg/ml,B组CCL2浓度>179.89 pg/ml。B组患者总的MACCE发生率及脑梗死的发生率明显高于A组(P<0.05)。Kaplan-Meier分析及Cox回归分析显示,血浆中CCL2水平与患者1年内发生MACCE存在相关关系。结论血浆中CCL2水平与STEMI患者预后独立相关。

Association between the expression of chemokine CCL2 in plasma and clinical outcomes in patients with ST elevation myocardial infarction

Objective To investigate the association between the expression of chemokine CCL2 in plasma and major adverse cardiac and cerebral events(MACCE) in patients with ST elevation myocardial infarction(STEMI).Methods A total of 420 patients with STEMI were admitted from June 2014 to October 2015.The general data and clinical trial data were collected,plasma CCL2 concentration was detected by ELISA with the venous blood.The patients were followed up for 1 year and the clinical end point was defined as MACCE.According to the median concentration of CCL2 in plasma of the patients,the patients were divided into Group A and Group B.Kaplan-Meier method was used to compare the incidence of MACCE in the two groups during 1 year of follow-up.Cox regression model was used to analyze the correlation between the plasma CCL2 concentration and MACCE.Results Plasma CCL2 concentration in patients with MACCE(including all-cause death,heart failure,stroke and recurrent myocardial infarction) was significantly higher than that in patients without MACCE.The median concentration of CCL2 in plasma of the patients was 179.89 pg/ml,in Group A was less than 179.89 pg/ml and in Group B was more than 179.89 pg/ml.The incidence of MACCE and cerebral infarction in Group B were significantly higher than those in Group A(P<0.05).Kaplan-Meier analysis and Cox regression analysis showed that the expression of CCL2 in plasma was related to the occurrence of MACCE in patients during 1 year.Conclusion The expression of CCL2 in plasma was independently associated with the prognosis of STEMI patients.