Correlation Analysis between Coronary Lesion Severity and Peripheral Blood Cell CD34~+ Ratio in the Coronary Heart Disease Patients Complicating Diabetes Mellitus
|School||Zunyi Medical College,|
|Course||Cardiovascular within science|
|Keywords||Coronary Heart Disease Diabetes Mellitus Endothelial Progenitor Cells high-sensitivity C-rective protein|
Objectives:To investigate the peripheral blood cell CD34+ ratio and evaluate the coronary lesion and clinical condition by the Syntax-score and the EuroScore systems in CHD patients complicating DM, and then reveal the relationship between the clinical conditions and the result of coronary angiography, and to try to find its mechanism.Methods:96 consecutive patients who recieved coronary angiography in the cardiovascular department of the Sichuan Province People’s Hosipital during November 2010 to January 2011 were enrolled. All those patients were divided into two groups according to the result of coronary angiography. One group was made up of coronary heart disease patients (group A, n=61) and the other one with non coronary heart disease patients (group B, n=35). The Group A was then divided into two sub-groups according to whether they was complicated with diabetes mellitus. Those CHD patients complicating DM were subgrouped to the A1 group (n=29). while the non-DM CHD patients were subgrouped to the A2 group (n=32). Their coronary lesions were classified by the ACC/AHA coronary lesion type standard, and the severity was measured by both the Syntax-score and the EuroScore systems. We took the blood samples. and check out the peripheral blood cell CD34+ ratio and the serum high-sensitive CRP level. Then. we use statistical analysis to reveal the relationship between the coronary lesion type, severity and the peripheral blood cell CD34+ ratio. serum hs-CRP level.Results:1. CD34- celles were found in the peripheral blood of both Group A and Group B. But the ratios of the CD34- cells in the Group Al (0.203±0.172%) and Group A2 (0.409±0.343%) were significantly lower than that of the group B (0.925±0.776%) (both P<0.01). While the CD34+ ratio of the Group A1 (0.203±0.172%) is significant lower than that of group A2 (0.409±0.343%) (P<0.05).2. The serum hs-CRP levels of the Group A1 (8.02±2.23 mg/L) and Group A2 (6.55±2.03 mg/L) were significantly higher than that of the group B (2.46±0.76 mg/L) (both P<0.01). While the serum hs-CRP level of the Group A1 (8.02±2.23 mg/L) is higher than that of the Group A2 (6.55±2.03 mg/L) (P<0.05).3. The peripheral blood cell CD34- ratio and the serum hs-CRP level was negatively correlated (r=-0.458,p=0.001).4. No significant ACC/AHA lesion type difference was found among those groups and sub-groups.5. The peripheral blood CD34+ cell ratio of the Syntax-score high-risk group is significant lower than that of the low-risk group [(0.200±0.063)% vs (0.362±0.323)％, P<0.05]. While no such difference was found between the intermediate-risk group with the high-risk group or the low-risk group.6. The Syntax average score of the CHD patients complicating DM was significantly higher than those without DM [(21.05±10.27)% vs (16.26±7.96)%. P<0.05].7. The peripheral blood CD34+ cell ratio of the Euroscore high-risk group is significant lower than that of the low-risk group [(0.320±0.285)% vs(0.688±0.661)%, P<0.05]. While no such difference was found between the intermediate-risk group with the high-risk group or the low-risk group.8. No significant EuroScore difference was found among those groups and sub-groups.Conclusion:1.The peripheral blood cells CD34+ ratio in the CHD patients complicating DM was significantly lower than that without DM.2. The peripheral blood cell CD34+ ratio decreased with the coronary lesions severity.3. The coronary lesions in the patients with DM were more severe and complicated compared with those without DM. 4. The peripheral blood cell CD34- ratio was negatively correlated with the serum hs-CRP level. We may infer that the endothelial injury is more severe in those with increased inflammatory response.