骨桥蛋白与高敏C反应蛋白对冠状动脉介入治疗后再狭窄的预测价值

Comparison of Diagnostic Value Between Osteopontin and High Sensitive C-reactive Protein on Restenosis after PCI

探讨血浆高敏C反应蛋白(hs-CRP)及骨桥蛋白(OPN)对冠状动脉介入治疗(PCI)后患者冠状动脉支架内再狭窄(ISR)发生的预测价值,并比较二者对ISR预测的准确性。收集2014年5月~2015年5月于笔者所在医院成功施行PCI并自愿随访冠状动脉造影(CAG)的患者206例,术后随访1年,根据复查CAG的结果将入选者分为再狭窄组(n=28)和无再狭窄组(n=178),复查CAG时检测两组患者血浆hs-CRP、OPN等生化指标,进行统计分析。再狭窄组患者hs-CRP及OPN水平均高于无再狭窄组,Logistic分析结果显示hs-CRP及OPN水平对PCI后发生ISR有独立的预测价值,当hs-CRP及OPN取最佳临界值时OPN对IRS诊断的特异性、准确性及阳性预测值均高于hs-CRP。相对于hs-CRP,OPN对PCI后发生ISR具有更好的预测价值,尤其是其诊断的特异性、准确性及阳性预测值更具优势,值得推广。

To explore the predictive value of plasma high sensitive C-reactive protein（hs-CRP）and osteopontin（OPN）levels on the in-stent restenosis（ISR）in patients after percutaneous coronary intervention（PCI）.A total of 206 patients successfully treated with PCI were examined with a follow-up CAG.Study subjects were divided into ISR group and nonISR group.The difference of serum hs-CRP,OPN and other clinical biochemical patameters between two groups was analyzed.The levels of serum hs-CRP and OPN were significantly higher in ISR group than that in non-ISR group in statistics.Multivariate logistic regression analysis revealed that the higher serum hs-CRP and OPN levels was an independent risk factor of ISR.At the optimal point,the specificity,accuracy and positive predictive rate by detecting OPN was higher than that of hs-CRP.Compared with hs-CRP,OPN on the predictive value of ISR after PCI is better,especially on the diagnostic specificity,accuracy and positive predictive rate.