血清MCP-1、OPG与急性心肌梗死患者PCI后再狭窄的关系

Relationship of serum monocyte chemoattractant protein 1 and osteoprotegerin with restenosis after PCI in patients with acute myocardial infarction

目的探讨血清单核细胞趋化蛋白1(MCP-1)、骨保护素(OPG)与急性心肌梗死患者经皮冠状动脉内介入治疗术(PCI)后再狭窄的关系。方法选取2015年2月至2016年2月在广元市第一人民医院心血管内科治疗的急性心肌梗死患者421例,均接受PCI治疗,其中术后再狭窄患者42例(狭窄组),无狭窄者379例(非狭窄组),比较两组PCI术后24 h MCP-1、OPG、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)以及患者一般资料及生化指标。结果狭窄组和非狭窄组患者的性别、年龄、吸烟、糖尿病、高血压、梗死部位及相关血管分布比较差异均无统计学意义(P>0.05);狭窄组PCI术后血清MCP-1、OPG、hs-CRP和TNF-α分别为(35.40±3.11)ng/L、(0.19±0.02)g/L、(3.34±0.42)ng/L和(15.03±3.12)ng/mL,明显高于非狭窄组的(29.31±4.06)ng/L、(0.13±0.01)g/L、(2.27±0.50)ng/L和(10.04±4.22)ng/mL,差异均有统计学意义(P<0.05);狭窄组和非狭窄组PCI术后血清三酰甘油(TC)、总胆固醇(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)及空腹血糖(FBG)比较差异均无统计学意义(P>0.05);Logistic回归分析结果显示,术后MCP-1和OPG水平是急性心肌梗死患者PCI后再狭窄的危险因素(OR=2.570、2.394,P<0.05)。结论急性心肌梗死PCI后再狭窄患者MCP-1、OPG、hs-CRP和TNF-α明显升高,其中MCP-1和OPG可能与术后再狭窄发生有一定关系。

Objective To investigate the relationship of serum monocyte chemoattractant protein 1（MCP-1）and osteoprotegerin（OPG） with restenosis after percutaneous coronary intervention（PCI） in patients with acute myocardial infarction.Methods A total of 421 patients with acute myocardial infarction,who admitted to our hospital from February 2015 to February 2016,were selected and treated with PCI.Among them,there were 42 patients with restenosis after surgery（stenosis group） and 379 patients without restenosis（non-stenosis group）.MCP-1,OPG,high sensitive C reactive protein（hs-CRP）,tumor necrosis factor（TNF-α） and the general data of patients and biochemical indexes of the two groups 24 h after PCI were compared.Results There was no significant difference in gender,age,smoking,diabetes,hypertension,location of infarction and the distribution of blood vessels between the stenosis group and the non-stenosis group（P0.05）;the serum MCP-1,OPG,hs-CRP and TNF-α in the stenosis group after PCI were（35.40±3.11） ng/L,（0.19±0.02） g/L,（3.34±0.42） ng/L and（15.03±3.12） ng/mL,respectively,which were significantly higher than（29.31±4.06） ng/L,（0.13±0.01） g/L,（2.27±0.50） ng/L and（10.04±4.22） ng/mL of the non-stenosis group（P0.05）;there was no significant difference in serum total cholesterol（TC）,triglyceride（TG）,high-densitylipoprotein cholesterol（HDL-C）,low-densitylipoprotein cholesterol（LDL-C） and fastingblood glucose（FBG） between the stenosis group and the non-stenosis group after PCI（P0.05）.Logistic regression analysis showed that MCP-1 and OPG levels were risk factors of restenosis after PCI in patients with acute myocardial infarction（OR=2.570,2.394,P0.05）.Conclusion The MCP-1,OPG,hs-CRP and TNF-α of patients with acute myocardial infarction restenosis after PCI are increased significantly,of which MCP-1 and OPG may be associated with restenosis after surgery.