PTX3、OPG及Hcy与ACS患者PCI术后支架内再次狭窄的相关性分析

Correlation between PTX3,OPG,Hcy and in⁃stent re⁃stenosis of patients with acute cor⁃onary syndrome after percutaneous coronary intervention

目的分析长正五聚蛋白3(PTX3)、骨保护素(OPG)及同型半胱氨酸(Hcy)与急性冠脉综合征(ACS)患者冠状动脉支架植入术(PCI)后支架内再次狭窄(ISR)的相关性。方法选取2017年1月至2019年1月收治的95例于本院进行PCI术治疗的ACS患者作为ACS组。根据PCI术后6~9个月复查冠状动脉造影的结果,分为ISR组(n=49)和N-ISR组(n=46)。选取60例同期因疑似ACS患者住院并经冠状动脉造影术证实血管狭窄直径<50%、血流正常且临床资料完整者作为对照组。比较ACS组与对照组PTX3、OPG及Hcy的水平;记录所有ACS患者PCI术后发生ISR的情况,采用多元Logistic回归分析影响ACS患者PCI术后发生ISR的独立危险因素。结果 ACS组PTX3、OPG及Hcy水平高于对照组,差异有统计学意义(P<0.05);ISR组与无N-ISR组年龄、性别、BMI、高血压病史、糖尿病史、血肌酐、甘油三酯、高密度脂蛋白胆固醇、总胆固醇比较差异无统计学意义(P>0.05);ISR组低密度脂蛋白胆固醇、左心室射血分数低于N-ISR组,APTX3、OPG、Hcy水平及吸烟人数高于N-ISR组,比较差异有统计学意义(P<0.05)。低左心室射血分数及高APTX3、OPG、Hcy水平为影响ACS患者PCI术后发生ISR的独立危险因素(P<0.05)。结论 APTX3、OPG、Hcy水平在ACS及术后IRS患者中显著升高,三者均为影响PCI术后发生ISR的独立危险因素,临床可将三者纳入指标检测体系,从而规避ACS患者PCI术后发生ISR的风险。

Objective To analyze the correlation between blood pentraxin 3(PTX3),osteoprote⁃gerin(OPG)and homocysteine(Hcy)and in⁃stent re⁃stenosis(ISR)of patients with acute coronary syn⁃drome(ACS)after percutaneous coronary intervention(PCI).Methods 95 patients with ACS who were treated by PCI in our hospital from January 2017 to January 2019 were selected as the ACS group.According to the results of reexamination of coronary angiography 6⁃9 months after PCI,they were divided into the ISR group(n=49)and the N⁃ISR group(n=46).In the same period,60 patients who were hospitalized for suspect⁃ed ACS during the same period and were confirmed by coronary angiography with vascular stenosis less than 50%,and had normal blood flow and complete clinical data were selected as the control group.The levels of PTX3,OPG and Hcy between the ACS group and the control group were compared.The occurrence of ISR in all ACS patients after PCI was recorded,and multivariate Logistic regression was used to analyze the independent risk factors that affect the occurrence of ISR in ACS patients after PCI.Results PTX3,OPG and Hcy levels in the ACS group were higher than those in the control group,and the difference was statistically signifi⁃cant(P<0.05).There was no difference in age,gender,BMI,history of hypertension,history of diabetes,blood creatinine,triglycerides,high⁃density lipoprotein cholesterol,and total cholesterol between the ISR group and the non⁃N⁃ISR group(P>0.05).The low⁃density lipoprotein cholesterol and left ventricular ejection fraction in the ISR group were lower than those in the N⁃ISR group,and the levels of APTX3,OPG,Hcy and the number of smokers were higher than those in the N⁃ISR group.The difference between the two groups was statistically significant(P<0.05).Low left ventricular ejection fraction and high APTX3 and OPG levels were independent risk factors for ISR in ACS patients after PCI(P<0.05).Conclusion The levels of APTX3,OPG,and Hcy are significantly increased in ACS and postoperative IRS patients.The three are independent risk factors that affect ISR after PCI.Clinically,they can be included in the index detection system to avoid the risk of ISR in ACS patients after PCI.