摘要
目的探讨血清血管生成素样蛋白4(angiopoietin-like protein 4,ANGPTL_(4))对经皮冠状动脉介入(percutaneous coronary intervention,PCI)术后支架内再狭窄(in-stent restenosis,ISR)的预测价值。方法选取2021年7月至2022年7月在右江民族医学院附属河池医院心血管内科接受择期PCI术的136例冠心病(coronary heart disease,CHD)患者,依据是否发生ISR分为ISR组26例、非ISR组110例;ISR组依据是否发生主要心血管不良事件(major adverse cardiovascular events,MACE)分为MACE组(n=11)、非MACE组(n=15);选取30名健康人群为对照组。酶联免疫吸附法测定血清ANGPTL_(4)水平,并采集基线资料。结果ISR组和非ISR组的性别、年龄、体质量指数(body mass index,BMI)、吸烟、高血压、糖尿病、高血脂、病变支数、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)及术后服药情况比较无统计学差异(P>0.05);ISR组的总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)及总胆红素(total bilirubin,TBIL)均高于非ISR组(P<0.05)。相较于对照组,非ISR组、ISR组的血清ANGPTL_(4)水平降低,且ISR组低于非ISR组(P<0.05)。MACE组的血清ANGPTL_(4)水平低于非MACE组(P<0.05)。受试者操作特征曲线(receiver operator characteristic,ROC)结果显示,血清ANGPTL_(4)预测PCI术后ISR的临界值为23.1 ng/mL,曲线下面积(area under the curve,AUC)为0.957(95%C I为0.907~0.984),敏感性为88.46%,特异性为92.73%。logistic多因素回归结果显示,低水平ANGPTL_(4)和高水平TBIL、TC是PCI术后ISR的独立危险因素。结论血清ANGPTL_(4)对ISR有较好的预测价值,低水平ANGPTL_(4)是PCI术后ISR的危险因素。
Objective To investigate the prognostic value of serum ANGPTL_(4) for in-stent restenosis(ISR)after percutaneous coronary intervention(PCI).Methods 136 patients with CHD undergoing elective PCI were selected and divided into ISR group(n=26)and non-ISR group(n=110)according to whether ISR occurred.ISR group was divided into MACE group(n=11)and non-MACE group(n=15)according to occurrence of major adverse cardiovascular events(MACE).Thirty healthy people were selected as control group.Serum ANGPTL_(4) levels were measured by enzyme-linked immunosorbent assay and baseline data were collected.Results There were no significant differences in gender,age,BMI,smoking,hypertension,diabetes,hyperlipidemia,number of lesions,TG,HDL-C and postoperative medication between ISR group and non-ISR group(P>0.05).The TC,LDL-C and TBIL in ISR group were higher than non-ISR group(P<0.05).Compared with control group,the serum ANGPTL_(4) level of non-ISR group and ISR group was decreased,and ISR group was lower than non-ISR group(P<0.05).The serum ANGPTL_(4) level of MACE group was lower than non-MACE group(P<0.05).ROC curve results showed that the critical value of serum ANGPTL_(4) for predicting ISR after PCI was 23.1 ng/mL,AUC was 0.957(95%CI:0.907~0.984),sensitivity was 88.46%,specificity was 92.73%.logistic multivariate regression results showed that low ANGPTL_(4) and high TBIL and TC were independent risk factors for ISR after PCI.Conclusion Serum ANGPTL_(4) has a good predictive value for ISR,and low ANGPTL_(4) level is a risk factor for ISR after PCI.
作者
韦颖
莫昌干
花冠杰
赖冬艳
韦利元
WEI Ying;MO Chang-gan;HUA Guan-jie;LAI Dong-yan;WEI Li-yuan(Department of Cardiology,Youjiang Nationalities Medicial College Affiliated Hechi Hospital,Hechi,Guangxi 547000,China;不详)
出处
《慢性病学杂志》
2024年第3期330-333,338,共5页
Chronic Pathematology Journal
基金
右江民族医学院2021年度校级科研课题(yy2021sk111)
关键词
冠心病
经皮冠状动脉介入治疗
再狭窄
Coronary heart disease
Percutaneous coronary intervention
In-stent restenosis
作者简介
通信作者:韦颖,大学本科,副主任医师,研究方向:心血管疾病防治,E-mail:81150946@qq.com
