心外膜脂肪和血清分泌型卷曲相关蛋白5与老年冠心病支架内再狭窄的相关性

Association of epicardial adipose tissue with serum secreted frizzled related protein 5 and instent restenosis in elderly CHD patients

目的探讨老年冠心病患者心外膜脂肪厚度(EATT)和心外膜脂肪体积(EATV)及血清分泌型卷曲相关蛋白5(Sfrp5)水平与冠状动脉支架内再狭窄(ISR)发生的相关性。方法选择首次PCI的老年冠心病患者510例,随访1年最终入组408例。根据冠状动脉造影复查结果分为ISR组62例和非ISR组346例。记录所有患者血清Sfrp5水平,CT测量EATT和EATV,收集一般临床资料。分析ISR发生的相关因素及与EATT、EATV、Sfrp5的关系。结果ISR组EATT、EATV明显高于非ISR组[(18.19±7.96)mm vs(13.87±9.34)mm,P<0.05;(150.38±75.40)cm^(3) vs(116.30±41.70)cm^(3),P<0.05],Sfrp5水平明显低于非ISR组[(20.11±8.28)μg/L vs(34.78±10.64)μg/L,P<0.05]。多因素logistic回归分析显示,SYNTAX评分、Sfrp5、EATT及EATV为老年冠心病患者PCI术后ISR的独立危险因素(P<0.05,P<0.01)。结论EATT、EATV和Sfrp5与老年冠心病患者PCI术后ISR密切相关,或可以作为临床预测ISR的指标。

Objective To study the association of epicardial adipose tissue thickness(EATT),epicardial adipose tissue volume(EATV)and serum secreted frizzled related protein 5(Sfrp5)level with in-stent restenosis(ISR)in elderly coronary heart disease(CHD)patients.Methods Four hundred and eight CHD patients were divided into ISR group(n=62)and ISR-free group(n=346)according to their coronary angiograpgy after 1-year follow-up.Their serum Sfrp5 level,EATT,EATV and general clinical data were recorded.The ISR-related factors and their relationship with EATT,EATV and serum Sfrp5 level were analyzed.Results The EATT was significantly thicker and the EATV was significantly larger while the serum Sfrp5 level was significantly lower in ISR group than in ISR-free group(18.19±7.96 mm vs 13.87±9.34 mm,P<0.05;150.38±75.40 cm3 vs 116.30±41.70 cm3,P<0.05;20.11±8.28μg/L vs 34.78±10.64μg/L,P<0.05).Multivariate logistic regression analysis showed that SYNTAX score,EATT,EATV and serum Sfrp5 level were the independent risk factors for ISR in elderly CHD patients after PCI(P<0.05,P<0.01).Conclusion EATT,EATV and serum Sfrp5 level are closely related with ISR and can thus be used as the predictors of ISR in elderly CHD patients after PCI.