血清铁蛋白与冠状动脉支架内再狭窄的相关性研究

Correlation analysis between serum ferritin and in-stent restenosis

目的探讨血清铁蛋白与冠状动脉支架内再狭窄(ISR)的相关性。方法回顾性纳入2017年10月~2018年10月解放军总医院收治的接受首次冠状动脉支架植入术的患者204例,根据术后6~12个月冠状动脉造影复查结果,将患者分为ISR组(54例)和无ISR组(150例),通过单因素及logistic多因素分析血清铁蛋白是否为ISR的独立危险因素。结果单因素分析发现,左主干病变(8.7%:24.1%,P=0.004)、>2个支架(22.7%:38.9%,P=0.021)、支架直径(3.00:2.75,P=0.012)、支架长度(23:24.5,P=0.024)、肌酐(75.14±15.25:80.19±20.32,P=0.058)、血清铁蛋白(167.05:237.85,P=0.059)、左室射血分数(62:61,P=0.066)与ISR正相关,高密度脂蛋白与ISR负相关(1.05:0.97,P=0.043)。将P<0.1的因素纳入logistic多因素分析发现,左主干病变、>2个支架、血清铁蛋白>200 ng/ml、左室射血分数≤50%与ISR独立相关(P<0.05)。结论血清铁蛋白>200 ng/ml可能与冠状动脉支架内再狭窄相关。

Objective To investigate the correlation between serum ferritin and in-stent restenosis(ISR).Methods Total of 204 patients who underwent the first coronary stent implantation from October 2017 to October 2018 in the PLA General Hospital were recruited,whoes clinical and angiographic data were collected.According to the following-up results of coronary angiography for 6~12 months post stenting,patients were divided into the ISR group and the non-ISR group.The serum ferritin as an independent risk factor for ISR was analyzed by single factor and Logistic multifactor regression analysis.Results Univariate analysis found that:left main disease(8.7%:24.1%,P=0.004),>2 stents(22.7%:38.9%,P=0.021),stent diameter(3.00:2.75,P=0.012),Stent length(23:24.5,P=0.024),creatinine(75.14±15.25:80.19±20.32,P=0.058),serum ferritin(167.05:237.85,P=0.059),left ventricular ejection Score(62:61,P=0.066)was positively correlated with ISR;HDL was negatively correlated with ISR(1.05:0.97,P=0.043);Factors with P<0.1 were included in Logistic multivariate analysis and found that left main disease,>2 stents,serum ferritin>200 ng/ml,and left ventricular ejection fraction≤50%were independently related to ISR(P<0.05).Conclusion Serum ferritin>200 ng/ml may be associated with restenosis in coronary arteries.