血浆生长停滞特异基因6水平与急性心肌梗死患者PCI术后再狭窄的相关性分析

Correlation between plasma growth arrest-specific gene 6 level and restenosis in patients with acute myocardial infarction after PCI

目的探讨血浆生长停滞特异基因6(Gas6)水平与急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后再狭窄的相关性。方法选取2018年9月至2019年9月于商丘市第一人民医院心血管内科接受PCI的AMI患者78例作为研究对象(观察组),根据术后12个月的冠脉造影复查结果将其再分为未再狭窄组(53例)和再狭窄组(25例),另选取同期健康体检者80例作为对照组。AMI患者PCI术前及术后7 d、健康体检者于体检时采集血液,酶联免疫(ELISA)法检测血浆Gas6水平和血清炎症因子白细胞介素(IL)-6、IL-18、肿瘤坏死因子-α(TNF-α)水平。采用Pearson法分析AMI患者PCI术后血浆Gas6水平与血清IL-6、IL-18、TNF-α水平的相关性,采用受试者工作特征(ROC)曲线评估PCI术后血浆Gas6水平对AMI患者PCI术后再狭窄的预测价值。结果观察组AMI患者PCI术前血浆Gas6水平及血清IL-6、IL-18、TNF-α水平较对照组均显著升高(P<0.05);AMI患者PCI术后血浆Gas6水平及血清IL-6、IL-18、TNF-α水平均较术前显著升高(P<0.05);再狭窄组AMI患者PCI术后血浆Gas6水平及血清IL-6、IL-18、TNF-α水平较未再狭窄组均显著升高(P<0.05);AMI患者PCI术后血浆Gas6水平与血清IL-6、IL-18、TNF-α水平均呈显著正相关(r=0.424、0.536、0.534,P均<0.05);PCI术后血浆Gas6水平预测AMI患者PCI术后发生再狭窄的曲线下面积为0.872(95%CI:0.775~0.969),截断值为54.57 ng/ml,敏感度为80.0%,特异性为88.7%。结论血浆Gas6在AMI发生及PCI术后水平升高,与炎症水平密切相关,其水平升高可预测AMI患者PCI术后发生再狭窄。

Objective To discuss the correlation between level of plasma growth arrest-specific gene 6(Gas6)and restenosis in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods AMI patients(n=78)undergone PCI were chosen into observation group from Department of Cardiovascular Medicine in the First People’s Hospital of Shangqiu City from Sept.2018 to Sept.2019,and divided further,according to results of coronary angiography after PCI for 12 months,into non-restenosis group(n=53)and restenosis group(n=25).Meanwhile healthy controls were chosen into control group(n=80).The blood samples were collected from AMI patients and healthy controls before and 7 d after PCI.The levels of Gas6 and serum inflammatory factors,including interleukin-6(IL-6),IL-18 and tumor necrosis factor-α(TNF-α),were detected by using enzyme-linked immunoassay(ELISA).The correlation among Gas6 level and IL-6,IL-18 and TNF-αwere analyzed by using Pearson method in AMI after PCI.The predictive value of Gas6 level after PCI was reviewed to restenosis by using receiver operating characteristic(ROC)curve in AMI patients after PCI.Results The levels of Gas6,IL-6,IL-18 and TNF-αincreased significantly in observation group compared with control group before PCI(P<0.05),and increased significantly in observation group after PCI than before(P<0.05).The levels of Gas6,IL-6,IL-18 and TNF-αincreased significantly in restenosis group compared with non-restenosis group(P<0.05).The level of Gas6 was positively correlated to levels of IL-6(r=0.424),IL-18(r=0.536)and TNF-α(r=0.534,all P<0.05)in AMI patients after PCI.The area under curve of Gas6 level in predicting restenosis was 0.872(95%CI:0.775-0.969),and cutoff value was 54.57 ng/mL,sensitivity was 80.0%and specificity was 88.7%in AMI patients after PCI.Conclusion The level of plasma Gas6 increases after AMI occurrence and after PCI,which is closely correlated to inflammation level.The increase of Gas6 level can predict restenosis in AMI patients after PCI.