首页|精神压力及淋巴细胞亚群变化与冠状动脉病变程度相关性研究

精神压力及淋巴细胞亚群变化与冠状动脉病变程度相关性研究

扫码查看
目的 探讨冠心病患者自我感知的精神压力程度、淋巴细胞亚群变化与冠状动脉(冠脉)病变程度的相关性.方法 纳入2023年9月至2024年5月首都医科大学附属北京安贞医院住院冠心病患者,用压力知觉量表(PSS-14)评估患者近1个月精神压力程度,PSS-14评分14~42分为精神压力正常,43~70分为精神压力增高.冠脉狭窄程度评估,根据Gensini评分系统计算总分,对每支冠脉病变狭窄程度进行定量评定.检测患者淋巴细胞亚群水平,包括:成熟T淋巴细胞百分比(CD3+%)及绝对值(CD3+)、辅助/诱导性T细胞百分比(CD3+CD4+%)及绝对值(CD3+CD4+)、细胞毒性/抑制性T细胞百分比(CD3+CD8+%)及绝对值(CD3+CD8+)、B淋巴细胞百分比(CD3-CD19+%)及绝对值(CD3-CD19+)、自然杀伤细胞NK百分比(CD3-CD56+16+%)及绝对值(CD3-CD56+16+)、T辅助细胞T抑制细胞比值(Th/Ts).用SPSS24.0软件进行统计分析.结果 本研究共纳入323例冠心病患者,平均年龄61(56,68)岁,其中男性203例、女性120例.精神压力增高的冠心病患者,Gensini评分显著高于精神压力正常的冠心病患者[37(19,64)比28(12,50)分,Z=-2.19,P=0.029].精神压力增高的男性冠心病患者Gensini评分、CD3+CD8+%、CD3+CD8+绝对值均显著高于精神压力正常的男性冠心病患者,分别为[39(20,58)比 26(12,45)分,Z=-2.37,P=0.018;28.3%(23.6%,36.6%)比 25.9%(21.0%,32.4%),Z=-2.05.P=0.041;485(346,675)比 396(309,510)个/μl,Z=-2.55,P=0.011].男性冠心病患者,PSS-14 评分与 Gensini 评分(r=0.181,P=0.011)、CD3+CD8+绝对值(r=0.162,P=0.038)均呈正相关.结论 研究显示精神压力程度与冠脉病变严重程度相关,且有性别差异,知觉到的精神压力越高的男性冠心病患者冠脉狭窄程度越重,其潜在机制可能与淋巴细胞亚群的调节有关.
Exploring the association between mental stress,lymphocyte subset variations,and coronary lesion severity
Objectives This study aimed to explore the association between perceived mental stress(MS),lymphocyte subset variations,and coronary lesion severity in patients with coronary artery disease(CAD).Methods Patients with CAD were enrolled in this study from September 2023 to May 2024.Perceived Stress Scale-14(PSS-14)was used to evaluate MS during the last 1 month.Lymphocyte subsets were analyzed,including the percentage and absolute counts of CD3+,CD3+CD4+,CD3+CD8+,CD3-CD19+,CD3-CD56+16+,and the Th/Ts ratio.Statistical analysis was conducted using SPSS 24.0.Results This study recruited patients with 323 CAD,with an average age of 61(56,68)years,including 203 males and 120 females.According to the PSS-14,a score of 14-42 and 43-70 were categorized as normal and increased MS,respectively.Patients with CAD with increased MS had significantly higher Gensini scores than those with normal MS[37(19,64)vs.28(12,50),Z=-2.19,P=0.029].Male CAD patients with increased MS exhibited significantly higher Gensini scores[39(20,58)vs.26(12,45),Z=-2.37,P=0.018],levels of CD3+CD8+%[28.3%(23.6%,36.6%)vs.25.9%(21.0%,32.4%),Z=-2.05,P=0.041],and CD3+CD8+absolute value[485(346,675)vs.396(309,510)cells/μl,Z=-2.55,P=0.011]than those with normal MS.In male patients with CAD,a positive correlation was observed between Gensini scores(correlation coefficient:0.181,P=0.011),PSS-14 scores,and CD3+CD8+absolute value(correlation coefficient:0.162,P=0.038).Conclusion This study reveals a positive correlation between MS and coronary stenosis severity,with notable sex differences.In male patients with CAD,higher levels of MS are associated with more severe coronary stenosis.The potential underlying mechanism may involve the regulation of lymphocyte subsets.

Coronary artery diseaseCoronary stenosisStressLymphocyte subsetsImmunity

迟云鹏、张丽军、黄晓蓉、沈笑然、饶培俊、李艳玮、陈海洋、刘梅颜

展开 >

首都医科大学附属北京安贞医院双心医学中心,北京 100029

山西医科大学第二医院心内科,太原 030000

首都医科大学附属北京安贞医院检验科,北京 100029

河南大学临床医学院,开封 475001

展开 >

冠心病 冠状动脉狭窄 压力 淋巴细胞亚群 免疫

2025

中华内科杂志
中华医学会

中华内科杂志

北大核心
影响因子:2.014
ISSN:0578-1426
年,卷(期):2025.64(1)
  • 1