FIB-4指数预测急性心肌梗死患者PCI术后支架内再狭窄的价值

Predictive value of FIB-4 Index in stent restenosis after PCI in patients with acute myocardial infarction

目的:探讨FIB-4指数预测急性心肌梗死(AMI)患者冠状动脉介入(PCI)术后支架内再狭窄(ISR)的价值。方法:选取我院心内科确诊为AMI并行PCI术的患者159例,根据随访冠状动脉造影结果分为无支架内再狭窄(NISR)组及ISR组。比较两组基本临床资料、手术资料、PCI术后服药情况、PCI前及随访时实验室结果等。采用多因素logistic回归分析发生ISR的相关因素,ROC曲线评价FIB-4预测ISR临床价值。结果:两组年龄、性别、高血压、糖尿病、术后服用药物及PCI前实验室结果等比较均无统计学差异(P>0.05)。与NISR组相比,ISR组行急诊PCI比例低(P<0.05)。ISR组随访时HDL-C水平及FIB-4指数显著高于NISR组(P<0.05)。多因素logistic回归分析显示,随访时FIB-4指数(OR=3.022,P=0.032)是ISR发生的独立危险因素。随访时FIB-4指数ROC曲线下面积为0.632(95%CI:0.524~0.740,P=0.024),诊断临界值为0.474,灵敏度为73.3%,特异度为52.7%。结论:PCI术后随访时FIB-4指数是发生ISR的危险因素。

Objective: To explore the predictive value of FIB-4 index in stent restenosis after percutaneous transluminal coronary intervention(PCI) in patients with acute myocardial infarction(AMI). Methods: A total of 159 patients with AMI received PCI in our hospital from June 2018 to October 2020. According to the results of re-examined for coronary angiography, they were divided into non-stent restenosis group(NISR group) and in-stent restenosis group(ISR group). The basic clinical data, surgical data, medications after PCI, laboratory results before the PCI and follow-up were compared. The multivariate logistic regression was used to analyze the related factors of ISR, and the ROC curve was used to evaluate FIB-4 to the clinical value of ISR. Results: There were no significant differences in age, gender, hypertension, diabetes, postoperative drug use and laboratory results before PCI between the two groups(P>0.05). Compared with the NISR group, the rate of emergency PCI in the ISR group was lower(P<0.05). The HDL-C level and FIB-4 index in the ISR group were significantly higher than those in the NISR group at follow-up(P<0.05). Multivariate logistic regression analysis showed that FIB-4 index at follow-up(OR=3.022, P=0.032) was an independent risk factor for ISR. At follow-up, the area under the FIB-4 index ROC curve was 0.632(95%CI: 0.524-0.740, P=0.024), the diagnostic critical value was 0.474, the sensitivity was 73.3%, and the specificity was 52.7%. Conclusion: FIB-4 index is a risk factor for ISR at follow-up after PCI.