摘要
目的 :探讨血清骨桥蛋白(OPN)及金属基质蛋白酶-9(MMP-9)水平变化对经皮冠状动脉介入治疗(PCI)后支架内再狭窄(ISR)的诊断价值。方法 :选择142例于我院接受PCI后复查冠状动脉造影检查的患者,根据冠状动脉造影结果分为再狭窄组(n=21)和无再狭窄组(n=121),复查冠状动脉造影时检测两组患者血清OPN、MMP-9等生化指标,比较两组患者临床资料、OPN及MMP-9等临床生化指标水平。结果:再狭窄组患者血清OPN及MMP-9水平显著高于无再狭窄组,差异有显著统计学意义(P<0.001);Logistic多因素回归分析显示,OPN及MMP-9升高均是PCI后ISR发生的独立危险因素[优势比(OR)=3.034及OR=2.861,P<0.01];在OPN及MMP-9预测ISR能力的受试者工作曲线(ROC)中,其曲线下面积为0.821及0.887,P<0.001;当OPN及MMP-9分别取3.68 ng/ml和415.24 ng/ml时,联合检测可增加检测的敏感性(90.48%)和阴性预测价值(98.06%)。结论:PCI后患者血清OPN及MMP-9水平与ISR密切相关,联合检测血清OPN及MMP-9水平对ISR的发生具有一定的预测价值,尤其是其阴性预测价值。
Objective： To explore the diagnostic value of combined detection of blood osteopontin（OPN） and matrix metalloproteinase-9（MMP-9） for in-stent restenosis（ISR） in patients after percutaneous coronary intervention（PCI）.Methods： A total of 142 patients who received post-PCI coronary angiography（CAG） in our hospital were studied. The patients were divided into 2 groups based on if there were ISR condition： ISR group, n=21and Non-ISR group, n=121. The blood levels of OPN and MMP-9 were detected upon the follow-up CAG conduction and the basic clinical information with biochemical indexes were compared between 2 groups.Results： Blood levels of OPN and MMP-9 were significantly higher in ISR group than those in Non-ISR group, P〈0.001. Multivariate logistic regression analysis revealed that elevated levels of OPN and MMP-9 were the independent risk factors for post-PCI ISR occurrence（OR=2.861 and OR=3.343, P〈0.01）. The ROC area of OPN and MMP-9 for predicting post-PCI ISR occurrence were 0.821 and 0.887, P〈0.001. Taking the optimal cut off value of OPN at 3.68 ng/ml and MMP-9 at 415.24 ng/ml, the combined detection could increase the sensitivity of detection（90.48%） and the negative predictive value（98.06%）.Conclusion： Blood levels of OPN and MMP-9 are closely related to ISR occurrence in post-PCI patients, combined detection has certain predictive value for ISR occurrence, especially for negative predictive value.
出处
《中国循环杂志》
CSCD
北大核心
2015年第7期635-638,共4页
Chinese Circulation Journal
