摘要
目的探讨血清内皮细胞特异性分子(endocan)联合壳多糖酶3样蛋白1(CHI3L1)对冠心病经皮冠状动脉介入术(PCI)后支架内再狭窄(ISR)和远期预后的预测价值。方法选取2015年9月-2017年9月中国人民解放军第92493部队医院心血管内科收治冠心病患者400例作为研究组,同期医院体检健康者100例作为健康对照组。冠心病患者均行PCI治疗,术后根据是否发生ISR分为ISR亚组(n=73)与非ISR亚组(n=327)。对患者行5年随访,根据预后不同分为预后不良亚组(n=53)与预后良好亚组(n=328)。采用酶联免疫吸附法检测血清endocan、CHI3L1水平。采用受试者工作特征(ROC)曲线分析血清endocan、CHI3L1对术后ISR、预后不良的预测价值。Logistic回归模型分析冠心病PCI术后预后不良的影响因素。结果ISR亚组与非ISR亚组血清endocan、CHI3L1水平高于健康对照组,且ISR亚组水平高于非ISR亚组(F/P=98.163/<0.001,1105.673/<0.001)。Logistic回归分析显示,年龄偏大、合并糖尿病、合并高血脂、冠状动脉狭窄程度偏高、术前Gensini评分偏高、BUN水平较高、TC水平较高、LDL-C水平较高、endocan水平较高及CHI3L1水平较高为冠心病患者PCI术后预后不良的危险因素[OR(95%CI)=1.048(1.012~1.086)、1.795(1.328~2.425)、1.641(1.259~2.137)、1.081(1.023~1.142)、1.034(1.013~1.055)、1.097(1.030~1.170)、1.102(1.047~1.159)、1.139(1.048~1.238)、2.025(1.319~3.112)、1.056(1.018~1.094)]。ROC分析显示,血清endocan、CHI3L1及其联合诊断评估模型对冠心病PCI术后ISR诊断的曲线下面积(AUC)分别为0.726、0.752、0.806,二者联合评估模型的诊断价值较高(Z/P=2.241/0.025,2.144/0.032);血清endocan、CHI3L1及其联合预测模型对PCI术后预后不良的预测价值的AUC分别为0.721、0.721、0.797,二者联合预测模型的预测价值较高(Z/P=2.044/0.041,1.986/0.047)。结论冠心病患者血清endocan、CHI3L1水平上升与冠心病PCI术后ISR的发生有关,且是冠心病PCI术�
Objective To investigate the predictive value of serum endothelial cell specific molecule(endocan)combined with chitosanase 3-like protein 1(CHI3L1)for in stent restenosis(ISR)and long-term prognosis after percutaneous coronary intervention(PCI)in patients with coronary heart disease.Methods From September 2015 to September 2017,400 patients with coronary heart disease were admitted to the Cardiovascular Department of the 92493 Military Hospital of the People's Liberation Army as the study group,and 100 healthy people in the hospital during the same period were selected as the healthy control group.All patients with coronary heart disease underwent PCI treatment,and were divided into ISR subgroups(n=73)and non ISR subgroups(n=327)based on the occurrence of ISR after surgery.Patients were followed up for 5 years and divided into subgroups with poor prognosis(n=53)and subgroups with good prognosis(n=328)based on different prognosis.Use enzyme-linked immunosorbent assay to detect serum levels of endocan and CHI3L1.The predictive value of serum endocan and CHI3L1 for postoperative ISR and poor prognosis was analyzed using the receiver operating characteristic(ROC)curve.Logistic regression model was used to analyze the influencing factors of poor prognosis after PCI for coronary heart disease.Results The serum endocan and CHI3L1 levels in the ISR subgroup and non ISR subgroup were higher than those in the healthy control group,and the ISR subgroup levels were higher than those in the non ISR subgroup(F/P=98.163/<0.001,1105.673/<0.001).Logistic regression analysis showed that older age,diabetes,hyperlipidemia,high degree of coronary artery stenosis,high preoperative Gensini score,high BUN level,high TC level,high LDL-C level,high endocan level and high CHI3L1 level were risk factors for poor prognosis of coronary heart disease patients after PCI[OR(95%CI)=1.048(1.012-1.086),1.795(1.328-2.425),1.641(1.259-2.137)1.081(1.023-1.142),1.034(1.013-1.055),1.097(1.030-1.170),1.102(1.047-1.159),1.139(1.048-1.238),2.025(1.319-3.1
作者
李红超
陈静波
于晓娜
吕中华
任子夫
Li Hongchao;Chen Jingbo;Yu Xiaona;Lyu Zhonghua;Ren Zifu(Department of Internal Medicine-Cardiovascular,92493 Military Hospital of the Chinese People's Liberation Army,Liaoning Province,Huludao 125000,China;不详)
出处
《疑难病杂志》
CAS
2023年第8期817-823,共7页
Chinese Journal of Difficult and Complicated Cases
基金
辽宁省自然科学基金指导计划项目(20170322)。
关键词
冠心病
内皮细胞特异性分子
壳多糖酶3样蛋白1
经皮冠状动脉介入术
支架内再狭窄
预后
Coronary heart disease
Endothelial cell specific molecule
Chitosanase 3-like protein 1
Percutaneous coronary intervention
In-stent restenosis
Prognosis
