转化生长因子β1基因多态性与老年患者冠状动脉支架内再狭窄的相关性分析

Relationship between TGF-β1 gene polymorphism and instent restenosis in elderly patients

目的探讨转化生长因子β1(TGF-β1)基因多态性与PCI术后的老年患者支架内再狭窄的相关性。方法回顾性收集我院2016年1月~2017年1月收治的PCI术后老年患者150例,根据是否发生支架内再狭窄,分为狭窄组33例和对照组117例。随访2年,观察2组TGF-β1基因多态性分布和临床特征差异。结果狭窄组TGF-β1509C/T基因型为CC比例,血清TGF-β1表达水平明显高于对照组[54.55%vs 27.35%,P=0.003;(16.47±4.38)μg/L vs(12.61±3.98)μg/L,P=0.000]。与对照组比较,狭窄组再次手术率、病死率、心肌梗死、心力衰竭、冠状动脉病变支数、支架数量、血小板聚集率、Gensini评分明显增高(P<0.05)。多因素logistics回归分析显示,509C/T基因型为CC、支架数量、血小板聚集率、血清TGF-β1升高是PCI术后老年患者支架内再狭窄的危险因素(95%CI:1.024~4.405,P=0.000;95%CI:1.145~3.507,P=0.000;95%CI:1.034~3.471,P=0.001;95%CI:1.023~3.532,P=0.012)。结论PCI术后老年患者支架内再狭窄可能与TGF-β1基因多态性分布有关。

Objective To study the relationship between TGF-β1 gene polymorphism and instent restenosis in elderly patients after PCI.Methods One hundred and fifty elderly patients who underwent PCI in our hospital from January 2016 to January 2017 were divided into stenosis group(n=33)and control group(n=117).They were followed up for 2 years,during which the distribution and clinical characteristics of TGF-β1 gene polymorphism were recorded.Results The rate of TGF-β1509C/T genotype CC and the TGF-β1 expression level of TGF-β1 were significantly higher in stenosis group than in control group(54.55%vs 27.35%,P=0.003;16.47±4.38μg/L vs 12.61±3.98μg/L,P=0.000).The reoperation rate and mortality,incidence of myocardial infarction and HF,platelet aggregation rate and coronary Gensini score were significantly higher,the number of diseased coronary artery branches and stents was significantly greater in stenosis group than in control group(P<0.05).Multivariate logistic regression analysis showed that 509C/T genotype CC,number of stents,platelet aggregation rate and elevated serum TGF-β1 level were the risk factors for instent restenosis in elderly patients after PCI(95%CI:1.024-4.405,P=0.000;95%CI:1.145-3.507,P=0.000;95%CI:1.034-3.471,P=0.001;95%CI:1.023-3.532,P=0.012).Conclusion Instent restenosis is related with the distribution of TGF-β1 gene polymorphism in elderly patients after PCI.