血清Adropin和肝素结合性表皮生长因子水平对冠心病患者经皮冠状动脉介入治疗后1年内支架内再狭窄的预测价值研究

Predictive Value of Serum Levels of Adropin and HB-EGF on In-stent Restenosis Within One Year After PCI in Coronary Heart Disease Patients

目的探讨血清Adropin和肝素结合性表皮生长因子(HB-EGF)水平对冠心病患者经皮冠状动脉介入治疗(PCI)后1年内支架内再狭窄(ISR)的预测价值。方法选取2014年5月—2016年6月在如皋市人民医院心内科行PCI的冠心病患者193例,随访1年,发生ISR者27例(ISR组),未发生ISR者166例(非ISR组)。冠心病患者PCI后1年内ISR的影响因素分析采用多因素Logistic回归分析;血清Adropin、HB-EGF水平与ISR患者血清超敏C反应蛋白(hs-CRP)水平的相关性分析采用Pearson相关性分析;绘制ROC曲线以评价血清Adropin、HB-EGF水平对冠心病患者PCI后1年内发生ISR的预测价值。结果本组患者ISR发生率为14.0%(27/193)。多因素Logistic回归分析结果显示,血清hs-CRP[OR=2.596,95%CI(2.060,3.272)]、HB-EGF[OR=1.866,95%CI(1.432,2.432)]水平是冠心病患者PCI后1年内发生ISR的危险因素(P<0.05),而血清Adropin水平是保护因素[OR=0.689,95%CI(0.572,0.830),P<0.05]。Pearson相关性分析结果显示,血清Adropin水平与ISR患者血清hs-CRP水平呈负相关(r=-0.531,P<0.001);血清HB-EGF水平与ISR患者血清hs-CRP水平呈正相关(r=0.635,P<0.001)。绘制ROC曲线显示,血清Adropin联合HB-EGF水平预测冠心病患者PCI后1年内发生ISR的曲线下面积(AUC)为0.88,分别高于血清Adropin水平的0.86及血清HB-EGF水平的0.81。结论血清Adropin、HB-EGF水平是冠心病患者PCI后1年内发生ISR的影响因素,且联合检测血清Adropin、HB-EGF水平对冠心病患者PCI后1年内ISR发生具有一定预测价值。

Objective To investigate the predictive value of serum levels of Adropin and HB-EGF on in-stent restenosis within 1 year after PCI in coronary heart disease patients. Methods From May 2014 to June 2016,a total of 193 coronary heart disease patients undergoing PCI were selected in the Department of Cardiology,the People＇ s Hospital of Rugao,all of them were followed up for 1 year,there into 27 cases occurred in-stent restenosis（ served as A group）,other 166 cases did not occurred in-stent restenosis（ served as B group）. Multivariate Logistic regression analysis was used to analyze the influencing factors of in-stent restenosis within 1 year after PCI in coronary heart disease patients; Pearson correlation analysis was used to analyze the correlations of serum levels of Adropin and HB-EGF with serum CRP level in A group; ROC curve was drawn to evaluate the predictive value of serum levels of Adropin and HB-EGF on in-stent restenosis within 1 year after PCI in coronary heart disease patients. Results The incidence of in-stent restenosis was 14. 0%（ 27/193）. Multivariate Logistic regression analysis results showed that,serum levels of hs-CRP [OR = 2. 596,95% CI（ 2. 060,3. 272） ] and HB-EGF [OR= 1. 866,95% CI（ 1. 432,2. 432） ] were risk factors of in-stent restenosis within 1 year after PCI in coronary heart disease patients（ P〈0. 05）,while serum Adropin level was the protective factor [OR = 0. 689,95% CI（ 0. 572,0. 830）, P〈0. 05]. Pearson correlation analysis results showed that,serum Adropin level was negatively correlated with serum hs-CRP level in A group（ r =-0. 531,P〈0. 001）,while serum HB-EGF level was positively correlated with serum hs-CRP level in A group（ r = 0. 635,P〈0. 001）. ROC curve showed that,AUC of serum Adropin level combined with serum HB-EGF level was 0. 88 in predicting in-stent restenosis within 1 year after PCI in coronary heart disease patients,which was significantly higher than that of serum levels of Adropin（ AUC = 0. 86） and HB-EGF（ AUC = 0. 81）. Conclusion Serum levels of Adropin and HBEGF are influencing factors of in-stent restenosis within 1 year after PCI in coronary heart disease patients,combined detection of serum levels of Adropin and HB-EGF has certain predictive value on in-stent restenosis within 1 year after PCI in coronary heart disease patients.