联合积分对经皮冠状动脉介入治疗术后支架内再狭窄的预测价值

Value of Combined Score in Predicting In-stent Restenosis After Percutaneous Coronary Intervention

目的研究碱性磷酸酶、γ-谷氨酰转肽酶及总胆红素构建的联合积分与经皮冠状动脉介入治疗(PCI)术后支架内再狭窄(ISR)的关系。方法选取2013年至1月至2016年至10月在郑州大学第一附属医院心内科成功进行PCI术且复查冠脉造影诊断为ISR的51例患者,选取同期复查冠脉造影无ISR的55例患者作为对照。计算联合积分,分析联合积分与PCI术后ISR的关系。结果二分类logistic回归分析结果显示,联合积分为1分组、2分组和3分组的ISR风险分别是积分为0分组的3.839、9.241和16.940倍。ROC曲线结果显示,联合积分预测ISR的最佳临界值为1.50,曲线下面积是0.737,敏感度为70.6%,特异度为69.1%。结论PCI术前联合积分高的冠心病患者,术后ISR的风险较高,且联合积分预测价值优于积分内的单一指标。

Objective To investigate the relationship between the combined score of alkaline phosphatase,gamma-glutamyl transpeptidase,total bilirubin and in-stent restenosis(ISR)after percutaneous coronary intervention(PCI).Methods A total of 51 patients with ISR diagnosed by coronary angiography after successful PCI in the First Affiliated Hospital of Zhengzhou University from January 2013 to October 2016 were selected,and 55 patients without ISR were selected for comparison during the same period.The combined score of every patient was calculated.The relationship between the combined score and ISR after PCI was analyzed.Results Binary logistic regression analysis showed that ISR risks in group with combined score of 1,group with combined score of 2,group with combined score of 3 were 3.839,9.241 and 16.940 times of that in the group with combined score of 0.ROC curve showed that the optimal critical value of combined score for predicting ISR was 1.50.The area under the curve was 0.737,and sensitivity was 70.6%,and specificity was 69.1%.Conclusion The risk of ISR after PCI increases in the patients with higher combined score before PCI.The predictive value of combined score is better than the single index in the combination.