骨桥蛋白对药物代谢酶CYP2C9正常代谢型冠心病介入治疗后支架内再狭窄的预测价值

Predictive value of osteopontin on in-stent restenosis after percutaneous coronary intervention in patients with CYP2C9 normal metabolic coronary heart disease

目的:探讨药物代谢酶CYP2C9基因(下称CYP2C9)正常代谢型冠心病患者行冠状动脉介入治疗(PCI)后,骨桥蛋白与hs-CRP、miR-663、miR-126对支架内再狭窄(ISR)的预测价值。方法:将在我院行PCI治疗的180例冠心病患者纳入随访,测定术后患者血清骨桥蛋白与hs-CRP、miR-663、miR-126水平变化,记录并分析12个月内患者的的ISR发生情况以及心血管事件发生情况,同时记录分析患者一般资料和用药情况。结果:随访结果显示,未发生狭窄患者156例,发生狭窄患者24例,未发生狭窄患者血清中骨桥蛋白与hs-CRP、miR-663表达量、miR-126表达量均低于再狭窄组,两组差异有统计学意义(P<0.05)。骨桥蛋白与hs-CRP具有最高敏感性,当hs-CRP取最佳临界值时,骨桥蛋白的预测特异性及准确性均高于hs-CRP、miR-663和miR-126,miR-663的预测价值高于miR-126,但其敏感性较低。结论:骨桥蛋白与hs-CRP、miR-663、miR-126对CYP2C9正常代谢型冠心病患者行PCI术后ISR有较好的预测价值,骨桥蛋白较其他三种预测准确性高,而且具有较高的敏感性和特异性,可作为临床诊断指标应用。

Objective： To investigate the predictive value of osteopontin and high-sensitivity C-reactive protein, miR-663 and miR-126 for in-stent restenosis（ISR） after coronary intervention in patients with normal metabolic coronary artery disease（CYP2 C9）. Methods： One hundred and eighty patients with coronary artery disease undergoing percutaneous coronary intervention（PCI）in our hospital were enrolled in the study. Serum osteopontin and high-sensitivity C-reactive protein, miR-663 and miR-126 levels were measured after operation. The patients were recorded and analyzed within 12 months Patients with ISR and cardiovascular events, as well as record and analyze the general information of patients and medication. Results： The follow-up result showed that there were 156 patients without stenosis and 24 patients with stenosis. The levels of osteopontin and high-sensitivity C-reactive protein in serum of patients without stenosis were lower than those of patients with re-expression of miR-663 The difference between the two groups was statistically significant（P〈0.05）. Osteopontin has the highest sensitivity to high-sensitivity C-reactive protein. When the critical value of high-sensitivity C-reactive protein is taken, the predictive specificity and accuracy of osteopontin are higher than that of high-sensitivity C-reactive protein, and the predictive value of miR-663 is high At miR-126, but its sensitivity is low. Conclusion： Osteopontin and high-sensitivity C-reactive protein, miR-663 and miR-126 have good predictive value for coronary stent restenosis after PCI in patients with normal metabolic coronary artery disease（CYP2 C9）.Osteopontin is more accurate than the other three predictions, and has high sensitivity and specificity, which can be used as a clinical diagnostic indicator.