空气污染物与急性冠脉综合征患者外周血细胞、心肌酶谱和炎症反应的关系
Relationship of Air Pollutants with Peripheral Blood Cells, Myocardial Enzymes, and Inflammatory Response of Patients with Acute Coronary Syndrome
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摘要:
目的 研究空气污染物与急性冠状动脉综合征患者(ACS)外周血细胞、心肌酶谱和炎症反应的关系,并进行ACS 的危险因素分析。 方法 以上海市某三甲医院2008-2009 年因ACS 通过“心脏介入绿色通道”途径入院的238 名患者为研究对象,检测患者的一般生化指标:胆固醇、三酰甘油及低密度脂蛋白胆固醇等;外周血细胞和炎症指标:白细胞计数、淋巴细胞百分比、高敏C反应蛋白等;心肌损伤标志物:肌酸激酶、肌钙蛋白、人羟脯氨酸糖蛋白等;同时收集大气污染物资料:粗颗粒物(PM10)、二氧化硫、二氧化氮和气象资料,采用Spearman 相关分析,分析大气污染物对ACS 患者的血液细胞和生化指标的影响。 结果 经Spearman 相关分析,PM10 与ACS 患者的淋巴细胞百分比具有相关关系(r=0.235,P< 0.05)。采用多元逐步回归分析方法,以ACS 患者的淋巴细胞百分比为应变量,共有自变量PM10(P=0.011)和性别(P=0.020)纳入模型。 结论 大气PM10 高浓度暴露可导致患者淋巴细胞百分比发生变化,影响免疫系统功能,提示PM10 可能是ACS 患者的一个危险因素。 Abstract:Objective To examine the effects of exposure to air pollutants on the peripheral blood cells, myocardial enzymes, and inflammatory response of patients with acute coronary syndrome (ACS), and to identify ACS risk factors. Methods Subjects included patients with ACS in Shanghai, China, who were admitted to a grade-three hospital through Cardiac Intervention Green Channel in 2008-2009. They were tested for the following biochemical indicators: general biochemical indicators, such as cholesterol, triglycerides, and low-density lipoprotein cholesterol; peripheral blood cells and inflammatory indicators, such as white blood cell count, lymphocyte percentage, and high-sensitivity C-reactive protein; myocardial injury markers: creatine kinase, troponin, and hydroxyproline glycoprotein. Atmospheric pollutants coarse particulate (PM10), sulfur dioxide, and nitrogen dioxide data and meteorological data were also collected. The associations between air pollutants and related risk factors of ACS were analyzed by Spearman correlation analysis. Results The lymphocyte percentage was closely associated with the recorded PM10 in the Spearman correlation analysis (r=0.235, P< 0.05). The results of multiple stepwise regression analysis showed when using lymphocyte percentages in ACS patients as a dependent variable, PM10 (P=0.011) and gender (P=0.020) were incorporated in the model. Conclusion Exposure to high concentrations of PM10 can lead to changes in patients' lymphocyte percentages and affect their immune system function. These findings indicate that PM10 is likely to be a risk factor for ACS.
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