摘要
目的探讨急性心肌梗死(AMI)患者经皮冠状动脉介入术(PCI)前后血清补体C1肿瘤坏死因子相关蛋白家族12(CTRP12)水平的变化及与对支架内再狭窄(ISR)的关系。方法选取2021年1月至2023年6月江苏省丹阳市人民医院确诊为AMI并行PCI的患者104例,统计术后12个月内ISR发生率,并根据复查冠脉造影结果将其分为ISR组和非ISR组。比较两组患者PCI术前和出院前日血清CTRP12水平。Logistic回归分析AMI患者PCI术后ISR的影响因素,受试者工作特征(ROC)曲线分析CTRP12对AMI患者PCI术后ISR的预测价值。结果104例AMI患者PCI术后12个月ISR发生率为14.4%(15/104)。ISR组术前TIMI血流≤1比例、白细胞计数、中性粒细胞计数、TC、LDL-C较非ISR组显著升高,出院前日血清CTRP12水平低于非ISR组(P<0.05)。非ISR组中,出院前日血清CTRP12水平较术前升高(P<0.05)。ISR组中,出院前日血清CTRP12水平较术前降低,但差异无统计学意义(P>0.05)。Logistic回归分析显示,出院前日血清CTRP12水平降低是AMI患者PCI术后ISR的独立危险因素(P<0.05)。ROC曲线分析结果显示,出院前日血清CTRP12对AMI患者PCI术后ISR预测的最佳截断点为3.89 ng/mL(敏感度93.3%,特异度73.0%),ROC曲线下面积(AUC)为0.849。结论出院前日血清CTRP12水平对AMI患者PCI术后ISR发生具有一定预测价值,CTRP12可能是AMI患者PCI术后ISR的治疗靶分子。
Objective To investigate changes in serum complement C1 tumor necrosis factor-related protein family 12(CTRP12)level before and after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI)and the relationship of CTRP12 level with in-stent restenosis(ISR).Methods A total of 104 patients who had been diagnosed with AMI and had undergone PCI at Danyang People's Hospital in Jiangsu Province from January 2021 to June 2023 were selected.The incidence of ISR within 12 months after PCI was counted,and they were divided into an ISR group and a non-ISR group according to the results of reviewed coronary angiography.Serum CTRP12 levels were compared between the two groups before PCI and on one day before discharge.Logistic regression was used to analyze the influencing factors of ISR in AMI patients after PCI.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of CTRP12 for ISR in AMI patients after PCI.Results The incidence of ISR in 104 AMI patients at 12 months after PCI was 14.4%(15/104).As compared with the non-ISR group,the ISR group had significant increases in preoperative TIMI flow of≤1,white blood cell count,neutrophil count,TC,and LDL-C,and a significant decline in serum CTRP12 level on one day before discharge(P<0.05).In the non-ISR group,serum CTRP12 level was significantly higher on one day before discharge than its baseline(P<0.05).In the ISR group,serum CTRP12 level on one day before discharge was lower than its baseline,but the difference was not statistically significant(P>0.05).Logistic regression analysis showed that a lower CTRP12 level on one day before discharge was an independent risk factor for ISR in AMI patients after PCI(P<0.05).ROC curve analysis showed that the optimal cut-off point of serum CTRP12 on one day before discharge for predicting ISR in AMI patients after PCI was 3.89 ng/mL(sensitivity 93.3%and specificity 73.0%),and the area under the ROC curve(AUC)was 0.849.Conclusions Serum CTRP12 level inone day before discharge has certain predictive value for ISR in AMI patients after PCI.CTRP12 may be a therapeutic target for ISR in AMI patients after PCI.
作者
张友明
龚军辉
朱红涛
ZHANG Youming;GONG Junhui;ZHU Hongtao(Department of Cardiology,Changzhou Maternal and Child Health Care Hospital,Changzhou Medical Center,Nanjing Medical University,Changzhou 213003,China;不详)
出处
《实用医学杂志》
CAS
北大核心
2024年第12期1671-1676,共6页
The Journal of Practical Medicine
基金
江苏省卫生健康委科研项目(编号:M2020077)。
