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CLIN CHEM:心肌梗死风险外周炎症生物标志:以社区为基础的前瞻性研究

2017-03-19 MedSci MedSci原创

先前关于慢性炎症和心肌梗死(MI)的大多数研究缺乏对高灵敏度C反应蛋白(hs-CRP)和白细胞(WBC)计数随时间变化的重复测量。 研究人员通过检查这些生物标志物的累积平均变化和纵向变化确定其是否与随后的MI风险相关。

最近,来自上海交通大学附属瑞金医院心内科及宾夕法尼亚大学营养科学学院研究团队报道了一项以社区为基础的针对心肌梗死风险外周炎症生物标志的前瞻性研究, 相关研究刊登于国际权威检验医学杂志CLIN CHEM上。

先前关于慢性炎症和心肌梗死MI)的大多数研究缺乏对高灵敏度C反应蛋白(hs-CRP)和白细胞(WBC)计数随时间变化的重复测量。 研究人员通过检查这些生物标志物的累积平均变化和纵向变化确定其是否与随后的MI风险相关。

在这项基于社区的前瞻性研究中,共纳入了82544名中国受试者 [66796名男性和15748名妇女;平均(SD)年龄为55.19.86y],并要求基线资料中无血管疾病或癌症疾病史(2006-2007)。 hs-CRPWBC和其它临床相关变量在随访期间每2年评估一次。

结果显示,经过6年的随访(2006-2012),我们记录了714MI事件。 hs-CRPWBC基线增高和累积平均浓度与MI的风险增加(两者的Pt趋势<0.001)一致。在校正他们的基线值和其它相关变量后, hs-CRP纵向增加(Ptrend <0.001),而非白细胞,与将来高风险MI相关。每年hs-CRP每增加1mg / L将来MI的风险增加9.3[危害比(HR= 1.09,95CI1.03; 1.17]。在hs-CRP/WBC评估后,有严重炎症状态的受试者(hs-CRP10mg/ LWBC10×109 / L),与其他受试者(hs-CRP <0.5 mg/L and WBC <5 × 109/L (HR = 6.64; 95% CI, 1.4929.6)相比,其MI发生在三个月内的风险高于MI发生在大于4年的风险。 hs-CRP / WBC评估后,MI发生在三个月内的与MI发生≥4年(HR = 2.95; 95CI0.90,9.65)相比,高级炎症状态(hs-CRP10mg/ LWBC10×109 / L)的参与者比hs-CRP <0.5 WBC <5×109 / LHR = 6.64; 95CI1.49-29.6)的参与者相更高。

研究结果表明血浆hs-CRP浓度和WBC能预测将来MI的风险。 hs-CRP的纵向增加也与MI高风险相关。

原始出处:

Zhijun Wu, Zhe Huang, Xiang Gao, et al. Peripheral Inflammatory Biomarkers for Myocardial Infarction Risk: A Prospective Community-Based Study. CLIN CHEM. Vol. 63, Issue 3.

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在国家自然科学基金项目(项目编号:81570316,81670457,81400362)等资助下,上海交通大学医学院附属瑞金医院张瑞岩研究团队在急性心肌梗死后心脏修复机制方面的研究取得重要进展。相关研究成果以 “Dectin-2 Deficiency Modulates Th1 Differentiation and Improves Wound Healing After Myocardial

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