| Objective To investigate the application significance between the per-centage of neutrophils?neutrophil to lymphocyte ratio?CD4~+T-cell?CD8~+T-cell?CD4~+/CD8~+,combining with contrast enhabced ultrasongraphy and coronary artery disease through examining the percentage of neutron-phils?neutrophilto lymphocyte ratio?CD4~+T-cell?CD8~+T-cell?CD4~+T/CD8~+on peripheral blood.Methods 220 patients with coronary artery disease(CAD)hospitalized in our Department of Cardiology,Guangzhou First People's Hospital between January 2017 and December 2017,including 119 males and 101 females,aged(67.2±8.5).There were 130patients in acute coronary syndrome group(ACS group),72 males and 58females,aged(67.3±7.0).There were 90 patients(SAP group)in stable angina pectoris group(SAP group),47 males and 43 females,aged(67.5±7.3);50 non-CAD patients who entrolled in the study as control group during the same period,hospitalized in our Department of Cardiology.there were 29 males and 21 females in control group;aged(66.1±8.1).The basic medical history of each patient included in the study was collected,such as the older age,gender,family history of coronary heart disease,blood pressure,diabetes,smoking and lipid status.All entrolled patients were collected from 3tubes of venous blood in the morning fasting on the second day of admission.The percentage of neutrophils was measured by nucleic acid fluorescence staining and laser flow cytometry,and the neutrophils to lymphocytes ratio was calculated(NLR).The CD3+T-cell,CD4+T-cell,CD8+-cell and CD4+/CD8+in entrolled patients were Detecting by ELISA.All patients were delectd with ultrasongraphy,and the largest plaque(argest plaque at least>2.0mm)was selected for contrast enhanced ultrasound and recorded the time to peak(TTP)and Density echo(DE)and the ratio of enhanced intensity in the plaque to that in the caroid artery lumen(Ratio).The percentages of neutrophils,NLR,T-lymphocyte subgroups deltected and parameter of contrast-enhanced ultrasonography(CEUS)were compared in the three groups.Pearson correlation analysis was used to analyze the correlation between Ratio of Carotid Artery Ultrasound with NLR?CD4~+/CD8~+in ACS patients.Multivariate logistic regression analysis was used to evaluate the predictive value between neutrophil percentage,NLR,T lymphocyte subgroups and CEUS parameter for ACS.Rusults1.The neutrophils percentage on peripheral blood of the ACS group and SAPgroup[(79.62±5.22)%,(72.30±5.76)%],NLR[(3.36±0.59),(2.35±0.45)]were higher than those in the control group.[(66.50±5.85)%],[(2.11±0.28)],and the ACS group was higher than the SAP group(P<0.05);2.the percentage of CD3~+T-cell on peripheral blood[(58.82±10.83),(54.62±9.05)%],CD4~+T-cell[(36.98±8.51),(36.69±7.97)%]and CD4~+/CD8~+[(1.84±0.48)?(1.36±0.56)]in ACS and SAP groups were higher than the control group,and those in SAP groups were larger than control group The percentage of CD8~+T-cell[(20.80±6.75)%?(22.78±6.81)%]were higher than those in the control group[(25.76±6.29)%],and the ACS group was less than SAP group,there was different(P<0.05);3.Plaque enhanced intensity DE[(9.01±1.95),(7.69±2.39)db/cm~2],Density echo and Ratio[(0.45±0.18),(0.27±)0.09)]were higher than the control group[(5.27±1.71)db/cm~2,(0.17±0.02)],and the ACS group was significantly larger than the SAP group(P<0.01);TTP[(17.11±2.97),(18.78±3.20)s]was less than those in control group[(20.56±3.05)s],and the ACS group was less than the SAP group(P<0.05);4.There was a positive correlation between ratio and NLR on peripheral blood in ACS patients(r=0.407,P=0.001),and there was a positive correlation with CD4~+/CD8~+on peripheral blood(r=0.0.271,P=0.001).5.ROC showed circulating Neut%?NLR and CD4+,CD4~+/CD8~+subgroups and DE,Ratio had great diagnostic values in unstable plague of CAD patients;6.Multivariate logistic regression analysis indicated that circulating Neut%?NLR?CD4~+,CD4~+/CD8~+T-cell subgroups,DE and Ratio were inde-pendent predictors of unstable plaque in CAD patients(P<0.05 or P<0.01).Comlusions Contrast enhanced carotid examination combined with leuk-ocyte and T-lymphocyte subgroups on peripheral blood were usefull to detect plaque instability and inflammatory response in CAD patients,and it was valuable to provide lots of objective basis for predicting and intervening unstable plaque in CAD patients... |
PDF Full Text Request