心肺血管病杂志2024，Vol.43Issue(4) ：358-365.DOI:10.3969/j.issn.1007-5062.2024.04.007

循环肿瘤坏死因子-α水平对稳定型冠状动脉粥样硬化发生与预后的影响

A study to investigate the predictive value of circulating tumor necrosis factor-α in patients with stable coronary atherosclerosis

吴玉芳 崔萍 蒋超鹏 张洪强
心肺血管病杂志2024，Vol.43Issue(4) ：358-365.DOI:10.3969/j.issn.1007-5062.2024.04.007
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  • 维普
  • 万方数据

循环肿瘤坏死因子-α水平对稳定型冠状动脉粥样硬化发生与预后的影响

A study to investigate the predictive value of circulating tumor necrosis factor-α in patients with stable coronary atherosclerosis

吴玉芳 1崔萍 1蒋超鹏 1张洪强1
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作者信息

  • 1. 213161 常州市武进中医医院检验科
  • 折叠

摘要

目的:冠状动脉粥样硬化(coronary artery atherosclerosis,CAD)是一种常见的心血管疾病,其发病机制与炎症反应密切相关.TNF-α是一种重要的促炎细胞因子,参与了 CAD的发展和进展.本研究旨在探讨循环TNF-α水平在稳定型CAD患者中的预测价值.方法:本研究是一项前瞻性队列研究,共纳入200例稳定型CAD患者和100例健康对照者,分别检测其血清TNF-α水平及各临床生化指标.利用冠状动脉造影评估CAD的严重程度,并使用超声心动图对心脏结构和功能进行全面评估,以监测CAD患者12个月随访期内的心血管事件发生.通过统计多因素Logistic回归及Cox比例风险回归分析与稳定型CAD相关的变量,调整统计模型中二级预防措施等因素,以排除其对结果的影响.并运用ROC分析评价TNF-α水平对稳定型CAD的诊断效能.结果:稳定型CAD患者的血清TNF-α水平显著高于对照组(P＜0.05),并且与CAD的严重程度呈正相关(r=0.68,P＜0.001).多因素Logistic回归分析表明,血清TNF-α水平是稳定型CAD的独立危险因素(OR=1.254,95％CI:1.126～1.409,P＜0.001).受试者工作特征曲线(ROC)分析表明,血清TNF-α水平对稳定型CAD的诊断具有较高的敏感性和特异性(AUC=0.858,95％CI:0.806～0.911,P＜0.001).随访期间,稳定型CAD患者中发生心肌梗死、心力衰竭或死亡的风险与血清TNF-α水平呈正相关(HR=1.181,95％CI:1.063～1.325,P＜0.01).结论:循环TNF-α水平在稳定型CAD患者中具有较高的预测价值,可作为CAD的诊断和预后评估的生物标志物.

Abstract

Objective:Coronary artery atherosclerosis(CAD)is a prevalent cardiovascular disease,with its pathogenesis closely related to inflammatory responses.TNF-α is a crucial pro-inflammatory cytokine involved in the development and progression of CAD.This study aims to explore the predictive value of circulating TNF-α levels in patients with stable CAD.Methods:This research is a prospective cohort study,including 200 stable CAD patients and 100 healthy controls,with their serum TNF-α levels and various clinical biochemical indicators tested.The severity of CAD was assessed using coronary angiography,and comprehensive evaluation of cardiac structure and function was performed using echocardiography,monitoring cardiovascular events in CAD patients during a 12-month follow-up.Multivariate Logistic regression analysis and Cox proportional hazard regression analysis were employed to identify variables related to stable CAD,adjusting for factors of secondary prevention measures in the statistical model,to eliminate their influence on the results.ROC analysis was used to evaluate the diagnostic efficiency of TNF-αlevels for stable CAD.Results:The serum TNF-α levels in patients with stable CAD were significantly higher than those in the control group(P＜0.05)and positively correlated with the severity of CAD(r=0.68,P＜0.001).Multifactor Logistic regression analysis revealed that serum TNF-α level is an independent risk factor for stable CAD(OR=1.254,95％CI:1.126-1.409,P＜0.001).Receiver operating characteristic(ROC)analysis indicated that serum TNF-α levels possess high sensitivity and specificity in diagnosing stable CAD(AUC=0.858,95％CI:0.806-0.911,P＜0.001).During the follow-up period,the risk of myocardial infarction,heart failure,or death among patients with stable CAD was positively correlated with serum TNF-α levels(HR=1.181,95％CI:1.063-1.325,P＜0.01).Conclusions:Circulating TNF-α levels exhibit substantial predictive value in patients with stable CAD and can serve as a biomarker for the diagnosis and prognosis assessment of CAD.

关键词

稳定性冠状动脉粥样硬化/肿瘤坏死因子-α/生物标志物/预测价值

Key words

Stable coronary artery atherosclerosis/Tumor necrosis factor-alpha/Biomarkers/Predictive value

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出版年

2024
心肺血管病杂志
北京市心肺血管疾病研究所,首都医科大学附属北京安贞医院

心肺血管病杂志

CSTPCD
影响因子：1.214
ISSN：1007-5062
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