摘要
目的探讨血管生成素样蛋白4(Angptl4)与经皮冠状动脉介入术(PCI)治疗的冠心病患者支架内再狭窄的关系。方法选取2020年1月至2021年1月于靖边县人民医院就诊的258例冠心病患者为研究对象,入组患者均接受PCI治疗且术后均进行随访,依据患者术后12个月冠状动脉造影结果,将其分为再狭窄组(41例)和非再狭窄组(217例)。采集两组患者血液标本,应用酶联免疫吸附试验检测两组患者血清Angptl4水平,采用多因素Logistic回归分析影响患者PCI治疗后支架内再狭窄的独立危险因素,采用受试者工作特征曲线分析血清Angptl4对PCI治疗的冠心病患者发生支架内再狭窄的预测价值。结果两组支架置入数量、左心室射血分数、术前Gensini评分、冠状动脉狭窄率、冠状动脉病变支数及病变长度比较,差异有统计学意义(P<0.05);与非再狭窄组比较,再狭窄组血清Angptl4水平降低,纤维蛋白原及D-二聚体水平升高(P<0.05);低Angptl4、高D-二聚体水平是影响冠心病患者PCI术后支架内再狭窄的独立危险因素(P<0.05);Angptl4预测PCI治疗的冠心病患者发生支架内再狭窄的曲线下面积为0.812(95%CI 1.106~2.149,P<0.05),诊断最佳临界值为21.38 ng/mL,约登指数为0.730,灵敏度为89.71%,特异度为83.29%。结论Angptl4在PCI治疗后发生支架内再狭窄的冠心病患者血清中水平降低,其低水平与冠心病患者发生支架内再狭窄有关,可作为冠心病患者预后的评价指标。
Objective To investigate the relationship between angiopoietin-like protein 4(Angptl 4)and in-stent restenosis in patients with coronary artery disease treated with percutaneous coronary intervention(PCI).Methods A total of 258 patients with coronary heart disease admitted to the People′s Hospital of Jingbian County from January 2020 to January 2021 were selected for the study.The patients were treated with PCI and followed up after the procedure.Based on the results of coronary angiography at 12 months after the procedure,they were divided into the restenosis group(41 cases)and the non-restenosis group(217 cases).Blood specimens were collected from two groups of patients,and serum Angptl4 levels were measured by applying enzyme-linked immunosorbent.The independent risk factors affecting in-stent restenosis after PCI was analyzed by multivariate Logistic regression,and the predictive value of serum Angptl4 on the occurrence of in-stent restenosis in patients with coronary artery disease treated by PCI was analyzed by using receiver operating characteristic curve.Results There were significant differences between the two groups on the number of stents placed,left ventricular ejection fraction,preoperative Gensini score,coronary stenosis rate,number of coronary artery lesion branches and lesion length(P<0.05).Compared with the non-restenosis group,serum Angptl4 level reduced and fibrinogen and D-dimer levels increased in the restenosis group(P<0.05).Low Angptl4 and high D-dimer levels were independent risk factors for in-stent restenosis after PCI in patients with coronary artery disease(P<0.05).The area under the curve predicted by Angptl4 for in-stent restenosis in patients with coronary heart disease treated by PCI was 0.812(95%CI 1.106-2.149,P<0.05),the best critical value for diagnosis was 21.38 ng/mL,the Youden index was 0.730,the sensitivity was 89.71%,the specificity was 83.29%.Conclusion The serum level of Angptl4 in coronary heart disease patients with in-stent restenosis after PCI treatment reduces,and its low level relates to in-stent restenosis in coronary heart disease patients,which could be used as a prognostic indicator for coronary heart disease patients.
作者
蔡喜
李银萍
王涵钰
CAI Xi;LI Yinping;WANG Hanyu(Department of Cardiology,People′s Hospital of Jingbian County,Yulin,Shaanxi 718500,China;Department of Cardiology,Ningxia Medical University General Hospital,Yinchuang,Ningxia 750003,China;Department of Endocrinology,the Second People′s Hospital of Shaanxi Province,Xi′an,Shaanxi 710000,China)
出处
《检验医学与临床》
CAS
2022年第24期3360-3363,共4页
Laboratory Medicine and Clinic
关键词
血管生成素样蛋白4
经皮冠状动脉介入术
冠心病
支架内再狭窄
angiopoietin-like protein 4
percutaneous coronary intervention
coronary artery disease
in-stent restenosis
