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外周血单个核细胞计数升高是急性心肌梗死患者左心室重构的独立预测因子。

Elevated peripheral blood mononuclear cell count is an independent predictor of left ventricular remodeling in patients with acute myocardial infarction.

机构信息

The Department of Medicine, Division of Cardiology, Nippon Medical School, Tokyo, Japan.

出版信息

J Cardiol. 2011 Mar;57(2):202-7. doi: 10.1016/j.jjcc.2010.10.003. Epub 2010 Dec 18.

Abstract

OBJECTIVES

Peripheral blood mononuclear cells (PBMCs) increase after acute myocardial infarction (AMI) and infiltrate to the infarct region. However, its impact on left ventricular (LV) remodeling remains unclear. The purpose of the present study was to clarify whether elevated PBMC count contributed to LV remodeling in patients with AMI.

SUBJECTS AND METHODS

A total of 131 patients with AMI were recruited. White blood cell (WBC), monocyte, and lymphocyte counts were measured at presentation and every 24h for five days after presentation. The correlation between PBMC count and LV remodeling was evaluated. LV remodeling was defined as an increase of LV end-diastolic volume index ≥ 10% at the 6-month follow-up left ventriculography.

RESULTS

Forty-eight patients had LV remodeling. Peak WBC (p=0.008), peak monocyte (p=0.001), and peak PBMC (p<0.001) counts were significantly greater in patients with LV remodeling than those without remodeling. Multivariate analysis revealed the peak PBMC count ≥ 3600/mm(3) was an independent predictor of LV remodeling [relative risk (RR) 3.243, p=0.011].

CONCLUSION

Increased PBMC count is significantly correlated with LV remodeling, thus suggesting that PBMCs play a pivotal role for the development of LV remodeling after AMI.

摘要

目的

外周血单核细胞(PBMCs)在急性心肌梗死(AMI)后增加,并浸润到梗死区域。然而,其对左心室(LV)重构的影响尚不清楚。本研究旨在阐明 AMI 患者中升高的 PBMC 计数是否有助于 LV 重构。

对象和方法

共招募了 131 名 AMI 患者。在就诊时和就诊后每天测量白细胞(WBC)、单核细胞和淋巴细胞计数,共 5 天。评估 PBMC 计数与 LV 重构之间的相关性。LV 重构定义为 6 个月随访左心室造影时 LV 舒张末期容积指数增加≥10%。

结果

48 例患者出现 LV 重构。与无重构患者相比,LV 重构患者的峰值 WBC(p=0.008)、峰值单核细胞(p=0.001)和峰值 PBMC(p<0.001)计数明显更高。多变量分析显示,峰值 PBMC 计数≥3600/mm(3)是 LV 重构的独立预测因子[相对风险(RR)3.243,p=0.011]。

结论

PBMC 计数的增加与 LV 重构显著相关,这表明 PBMC 在 AMI 后 LV 重构的发展中起关键作用。

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