Department of Cardiology, The First Affiliated Hospital, Harbin Medical University, Harbin, China.
Department of Extracorporeal Life Support, The People's Hospital of Gaozhou, Gaozhou, China.
J Clin Lab Anal. 2022 Jun;36(6):e24469. doi: 10.1002/jcla.24469. Epub 2022 May 6.
T helper (Th) cells are closely involved in vascular inflammation, endothelial dysfunction, and atherogenesis, which are the hallmarks of aortic dissection (AD). This study aimed to evaluate the clinical value of Th1, Th2, and Th17 cell measurements in Stanford type A AD patients.
Stanford type A AD patients (N=80) and non-AD patients with chest pain (N = 40) were recruited. Then, Th1, Th2, and Th17 cells in peripheral blood CD4 T cells from all participants were detected by flow cytometry. The 30-day mortality of Stanford type A AD patients was recorded.
Th1 and Th17 cells were higher, while Th2 cells were lower in Stanford type A AD patients compared with non-AD patients (all p < 0.001). Meanwhile, Th1 cells (area under curve (AUC): 0.734, 95% confidence interval (CI): 0.640-0.828), Th2 cells (AUC: 0.841, 95% CI: 0.756-0.925), and Th17 cells (AUC: 0.898, 95% CI: 0.839-0.957) could distinguish Stanford type A patients from non-AD patients. Moreover, Th1 cells (p = 0.037) and Th17 cells (p = 0.001) were positively related to CRP, and Th17 cells (p = 0.039) were also positively associated with D-dimer in Stanford type A AD patients. Furthermore, Th17 cells were elevated in deaths compared with survivors (p = 0.001), also, it could estimate 30-day mortality risk in Stanford type A AD patients with an AUC of 0.741 (95% CI: 0.614-0.867), which was similar to the value of CRP (AUC: 0.771, 95% CI: 0.660-0.882), but lower than the value of D-dimer (AUC: 0.818, 95% CI: 0.722-0.913).
Th1, Th2, and Th17 cells are dysregulated, but only the Th17 cells relate to CRP, D-dimer, and 30-day mortality risk in Stanford type A AD patients.
辅助性 T 细胞（Th）在血管炎症、内皮功能障碍和动脉粥样硬化形成中起重要作用，这些都是主动脉夹层（AD）的标志。本研究旨在评估 Th1、Th2 和 Th17 细胞测量在 Stanford 型 A 型 AD 患者中的临床价值。
招募 Stanford 型 A 型 AD 患者（N=80）和胸痛的非 AD 患者（N=40）。然后，通过流式细胞术检测所有参与者外周血 CD4 T 细胞中的 Th1、Th2 和 Th17 细胞。记录 Stanford 型 A 型 AD 患者的 30 天死亡率。
与非 AD 患者相比，Stanford 型 A 型 AD 患者的 Th1 和 Th17 细胞升高，而 Th2 细胞降低（均 P<0.001）。同时，Th1 细胞（曲线下面积（AUC）：0.734，95%置信区间（CI）：0.640-0.828）、Th2 细胞（AUC：0.841，95% CI：0.756-0.925）和 Th17 细胞（AUC：0.898，95% CI：0.839-0.957）可区分 Stanford 型 A 型患者与非 AD 患者。此外，Th1 细胞（p=0.037）和 Th17 细胞（p=0.001）与 CRP 呈正相关，Th17 细胞（p=0.039）与 Stanford 型 A 型 AD 患者的 D-二聚体也呈正相关。此外，死亡患者的 Th17 细胞水平高于存活患者（p=0.001），并且其 AUC 为 0.741（95%CI：0.614-0.867），可用于估计 Stanford 型 A 型 AD 患者 30 天的死亡率风险，这与 CRP 的 AUC（0.771，95%CI：0.660-0.882）相似，但低于 D-二聚体的 AUC（0.818，95%CI：0.722-0.913）。
Th1、Th2 和 Th17 细胞失调，但只有 Th17 细胞与 Stanford 型 A 型 AD 患者的 CRP、D-二聚体和 30 天死亡率风险相关。
