超敏C反应蛋白与支架内再狭窄的相关性分析

Correlation analysis of high-sensitivity C-reactive protein and in-stent restenosis

目的:目前经皮冠状动脉置入药物洗脱支架(DES),DES再狭窄的发生机制尚未完全清楚,研究相关因素是减少其发生的关键。方法 :回顾分析2017年1月至2020年5月,于北京航天总医院住院复查冠状动脉造影的病例171例,排除合并感染、支气管哮喘,风湿免疫性疾病(9例),共162例患者纳入研究,其中支架内再狭窄患者77例以及非支架内再狭窄患者85例。比较两组临床资料及血液生化指标差异。多因素Logistic回归分析血清学指标与支架内再狭窄的相关性。结果:ISR组患者高敏CRP[1.09 (0.47, 2.36)vs. 0.59 (0.32,1.18)mg/L]、同型半胱氨酸[(15.22±9.93)vs.(12.33±5.67)μmol/L]、TG[1.39 (1.04,1.82)vs. 0.59(0.32,1.18)mmol/L]、小而密的LDL-C[0.63(0.47,0.81)vs. 0.57(0.41,0.73)mmol/L]显著高于非ISR组,而HDL-C[(1.05±0.22)vs.(1.13±0.27)mmol/L]显著低于非ISR组。多因素Logistic回归分析显示,hs-CRP与支架内再狭窄呈正相关(OR=1.81,95%CI:1.18~2.79,P=0.01)。ROC曲线显示hs-CRP对支架内再狭窄具有一定的诊断价值,曲线下面积为0.653,P=0.001。结论 :hs-CRP水平与冠状动脉支架内再狭窄密切相关,是支架内再狭窄的诊断因素之一,可作为冠状动脉内再狭窄防治的预测因子。

Objective: Percutaneous coronary artery placement with drug-eluting stents(DES) has become the preferred strategy for many patients with coronary artery disease, which can improve clinical prognosis and reduce mortality. However, in-stent restenosis(ISR) remains an urgent problem, and the mechanism of DES restenosis is not fully understood. The mechanism of DES restenosis is not fully understood, and studying the factors associated with ISR is the key to reduce its occurrence. Methods: A retrospective analysis of 171 cases hospitalized for coronary angiography review at Beijing Aerospace General Hospital from January 2017 to May 2020, excluding combined infections, bronchial asthma, and rheumatic immune diseases(9 cases), a total of 162 patients were included in the study, including 77 patients with ISR as well as 85 patients with non-ISR. The clinical data and differences in blood biochemical indexes between the two groups were compared. Multi-factor logistic regression was used to analyze the correlation between serological indices and in-stent restenosis. Results: Hs-CRP [1.09(0.47, 2.36) vs. 0.59(0.32, 1.18) mg/L], homocysteine [(15.22±9.93) vs.(12.33±5.67) μmol/L], TG [1.39(1.04,1.82) vs. 0.59(0.32,1.18) mmol/l], and small and dense LDL-C [0.63(0.47, 0.81) vs. 0.59(0.32, 1.18) mmol/L] in the ISR group were significantly higher than those in the non-ISR group;HDL cholesterol [(1.05±0.22)vs.(1.13±0.27) mmol/L] in ISR group was significantly lower than in the non-ISR group. Multifactorial logistic regression analysis showed that high-sensitivity C-reactive protein was positively correlated with ISR(OR=1.81, 95% CI: 1.18-2.79, P=0.01). The ROC curve showed that high-sensitivity C-reactive protein had a diagnostic value for in-stent restenosis, with an area under the curve of 0.653 and a P value of 0.001.Conclusions: High-sensitivity C-reactive protein level is closely associated with ISR in coronary arteries,is one of the diagnostic factors of in-stent restenosis, and can be used as a predictor of in-stent restenosis prevention and treatment.