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经皮冠状动脉介入治疗前后Th细胞和调节性T细胞的纵向变化及其在急性综合征患者中的相互关系和预后价值

Longitudinal Variations in Th and Treg Cells Before and After Percutaneous Coronary Intervention, and Their Intercorrelations and Prognostic Value in Acute Syndrome Patients.

作者信息

Chen Xinjing, Fang Mingcheng, Hong Jingxuan, Guo Yansong

机构信息

Department of Cardiology, Provincial Clinical Medical College of Fujian Medical University, Provincial Hospital Affiliated to Fuzhou University, Fujian Institute of Cardiovascular Disease, Fujian Provincial Hospital, 134 East Street, Fuzhou, 350001, China.

出版信息

Inflammation. 2025 Feb;48(1):316-330. doi: 10.1007/s10753-024-02062-x. Epub 2024 Jun 14.

Abstract

T helper (Th) and regulatory T (Treg) cells regulate atherosclerosis, plaque, inflammation to involve in acute coronary syndrome (ACS). The current study aimed to investigate the clinical implications of Th and Treg cells in ACS patients receiving percutaneous coronary intervention (PCI). Blood Th1, Th2, Th17 and Treg cells were detected in 160 ACS patients before PCI, after PCI, at 1 month (M). Short physical performance battery (SPPB) at M1/M3 and major adverse cardiac event (MACE) during follow-ups were evaluated. Th1 and Th17 both showed upward trends during PCI, then greatly declined at M1 (P < 0.001). Th2 exhibited an upward trend during PCI but decreased slightly at M1 (P < 0.001). Treg remained stable during PCI but elevated at M1 (P < 0.001). Moreover, a positive correlation between Th1 and Th17, a negative correlation between Th17 and Treg, were discovered at several timepoints (most P < 0.050). Interestingly, the receiver operating curve (ROC) analyses revealed that Th1 [area under curve (AUC) between 0.633-0.645] and Th17 (AUC between 0.626-0.699) exhibited values estimating SPPB score <= 6 points at M1 or M3 to some extent. Importantly, Th1 (AUC between 0.708-0.710), Th17 (AUC between 0.694-0.783), and Treg (AUC between 0.706-0.729) predicted MACE risk. Multivariate models involving Th and Treg cells along with other characteristics revealed acceptable values estimating SPPB score <= 6 points at M1 or M3 (AUC between 0.690-0.813), and good values predicting MACE risk (AUC between 0.830-0.971). Dynamic variations in Th and Treg cells can predict the prognosis of ACS patients receiving PCI.

摘要

辅助性T(Th)细胞和调节性T(Treg)细胞调节动脉粥样硬化、斑块和炎症,参与急性冠状动脉综合征(ACS)的发生发展。本研究旨在探讨Th细胞和Treg细胞在接受经皮冠状动脉介入治疗(PCI)的ACS患者中的临床意义。检测了160例ACS患者在PCI术前、术后及术后1个月时血液中的Th1、Th2、Th17和Treg细胞。评估了术后1个月/3个月时的短身体功能量表(SPPB)评分以及随访期间的主要不良心脏事件(MACE)。Th1和Th17在PCI期间均呈上升趋势,然后在术后1个月时大幅下降(P<0.001)。Th2在PCI期间呈上升趋势,但在术后1个月时略有下降(P<0.001)。Treg在PCI期间保持稳定,但在术后1个月时升高(P<0.001)。此外,在几个时间点发现Th1与Th17呈正相关,Th17与Treg呈负相关(大多数P<0.050)。有趣的是,受试者工作特征曲线(ROC)分析显示,Th1[曲线下面积(AUC)在0.633 - 0.645之间]和Th17(AUC在0.626 - 0.699之间)在一定程度上能够预测术后1个月或3个月时SPPB评分≤6分的情况。重要的是,Th1(AUC在0.708 - 0.710之间)、Th17(AUC在0.694 - 0.783之间)和Treg(AUC在0.706 - 0.729之间)能够预测MACE风险。包含Th细胞和Treg细胞以及其他特征的多变量模型在预测术后1个月或3个月时SPPB评分≤6分方面显示出可接受的值(AUC在0.690 -

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