UA、DD及HCY水平对急性冠脉综合征患者PCI术后再次狭窄的影响

Effects of UA,DD and HCY levels on re-stenosis in patients with acute coronary syndrome after PCI

目的探讨血尿酸(UA)、D二聚体(DD)及同型半胱氨酸(HCY)水平对急性冠脉综合征(ACS)患者经皮冠状动脉介入(PCI)术后再次狭窄的影响。方法选取2016年6月至2020年9月本院住院部治疗的96例ACS患者,根据PCI术后有无再次狭窄分为:PCI术后再次狭窄组(46例,其中轻度狭窄22例,中度狭窄14例,重度狭窄10例)、PCI术后未再次狭窄组(50例),分别对比2组及不同程度狭窄的ACS患者UA、DD及HCY水平。分析影响ACS患者PCI术后再次狭窄的相关危险因素。结果PCI术后再次狭窄组DD、UA、HCY水平均显著高于PCI术后未再次狭窄组,差异具有统计学意义(P<0.05)。重度狭窄ACS患者DD、UA、HCY水平高于中度狭窄及轻度狭窄ACS患者,差异具有统计学意义(P<0.05)。中度狭窄ACS患者DD、UA、HCY水平高于轻度狭窄的ACS患者(P<0.05)。高血压史、糖尿病史、陈旧性心肌梗死史、既往PCI史、中风病史、DD异常升高、UA异常升高、HCY异常升高为影响ACS患者PCI术后再次狭窄的独立危险因素(P<0.05)。DD、UA、HCY及三者联合检测RCC曲线下面积分别为:0.883、0.677、0.768、0.943,各指标曲线下面积以联合检测最大。结论DD、UA、HCY三者联合检测对ACS患者PCI术后冠脉再次狭窄发生的预测价值较高,临床使用价值大。

Objective To explore the effect of urico acid(UA),D-dimer(DD)and homocysteine(HCY)levels on the re-stenosis after percutaneous coronary intervention(PCI)in patients with acute coronary syndrome(ACS).Methods 96 ACS patients treated in this inpatient department from June 2016 to September 2020 were seleted.According to whether there was re-stenosis or not after PCI,they were divided into:re stenosis group after PCI(46 cases,including 22 cases with mild stenosis,14 cases with moderate stenosis,and 10 cases with severe stenosis),and non-re-stenosis group(50 cases)after PCI.The levels of UA,DD and HCY in the two groups and in ACS patients with different degrees of stenosis were compared.The related risk factors that affect ACS patients with re-stenosis after PCI were analyzed.Results The levels of DD,UA and HCY in the re-stenosis group after PCI were significantly higher than those in the non-re-stenosis group after PCI,the difference was statistically significant(P<0.05).The levels of DD,UA,and HCY in patients with severe stenosis were higher than those with moderate stenosis and those with mild stenosis.The difference was statistically significant(P<0.05).The levels of DD,UA and HCY in ACS patients with moderate stenosis were higher than those in ACS patients with mild stenosis(P<0.05).History of hypertension,diabetes,history of old myocardial infarction,history of previous PCI,history of stroke,abnormal increase in DD,abnormal increase in UA,and abnormal increase in HCY were independent risk factors for re-stenosis in ACS patients after PCI(P<0.05).④The area under the RCC curve of DD,UA,HCY and the three joint detections were 0.883,0.677,0.768,0.943,and the area under the curve of joint detection was the largest.Conclusion The combined detection of DD,UA,and HCY has a higher predictive value for the recurrence of coronary artery stenosis after PCI in ACS patients,and has great clinical value.