Division of Nephrology, Hypertension & Transplantation, University of Florida, Gainesville, FL, USA.
Renal Section, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA.
Semin Dial. 2021 Mar;34(2):163-169. doi: 10.1111/sdi.12943. Epub 2020 Dec 5.
Circulating endothelial cells (CEC) are thought to be markers of endothelial injury. We hypothesized that the numbers of CEC may provide a novel means for predicting long-term survival and cardiovascular events in hemodialysis patients. 54 hemodialysis patients underwent enumeration of their CEC number. We retrospectively analyzed their survival and incidence of adverse cardiovascular events. 22 deaths (41%) were noted over the median follow up period of 3.56 years (IQR 1.43-12) and 6 were attributed to cardiovascular deaths (11%) of which 1 (4%) was in the low CEC (CEC<20 cells/ml) and 5 (19%) in the high CEC (CEC≥20 cells/ml) group. High CEC was associated with worse cardiovascular survival (p = 0.05) and adverse cardiac events (p = 0.01). In multivariate analysis, CEC >20 cells/ml was associated with a 4-fold increased risk of adverse cardiac events (OR, 4.16 [95% CI,1.38-12.54],p = 0.01) while all-cause mortality and cardiovascular mortality were not statistically different. In this hemodialysis population, a single measurement of CEC was a strong predictor of long term future adverse cardiovascular events. We propose that CEC may be a novel biomarker for assessing cardiovascular risk in dialysis patients.
循环内皮细胞（CEC）被认为是内皮损伤的标志物。我们假设 CEC 的数量可能为预测血液透析患者的长期生存和心血管事件提供一种新方法。54 名血液透析患者进行了 CEC 数量的计数。我们回顾性分析了他们的生存和不良心血管事件的发生率。在中位数为 3.56 年（IQR 1.43-12）的随访期间，有 22 例死亡（41%），其中 6 例归因于心血管死亡（11%），其中 1 例（4%）死于低 CEC（CEC<20 个细胞/ml），5 例（19%）死于高 CEC（CEC≥20 个细胞/ml）组。高 CEC 与较差的心血管生存相关（p=0.05）和不良心脏事件相关（p=0.01）。在多变量分析中，CEC>20 个细胞/ml 与不良心脏事件的风险增加 4 倍相关（OR，4.16[95%CI，1.38-12.54]，p=0.01），而全因死亡率和心血管死亡率无统计学差异。在该血液透析人群中，CEC 的单次测量是长期未来不良心血管事件的强烈预测指标。我们提出 CEC 可能是评估透析患者心血管风险的一种新型生物标志物。
