经桡动脉冠状动脉介入术后桡动脉管径及血清PAPPA、IL-6、ICAM-1水平变化的意义

Significance of Changes in Radial Artery Diameter and Serum PAPPA,IL-6 and ICAM-1 Levels after Transradial Approach Coronary Intervention

目的:探究经桡动脉(TRA)冠状动脉介入术后桡动脉管径及血清妊娠相关蛋白A(PAPPA)、白介素6(IL-6)、细胞间黏附因子-1(ICAM-1)水平变化及其临床意义。方法:选择我院心内科2020年2月—2021年2月期间收治的冠心病患者102例,均择期接受经桡动脉冠状动脉介入术,检测患者血清PAPPA、IL-6、ICAM-1、桡动脉管径,随访患者预后并分为预后良好组、预后不良组,分析血清PAPPA、IL-6、ICAM-1水、桡动脉管径对患者预后的预测价值。结果:术后1d患者血清PAPPA、IL-6、ICAM-1水平较术前明显升高,术后3d明显降低,术后1d、3d桡动脉管径依次明显降低(P<0.05)。102例TRA冠状动脉介入患者,13.73%出现不良心血管事件。预后不良组年龄≥60岁占比、TC、LDL、术后血清PAPPA、IL-6、ICAM-1水平、桡动脉管径较预后良好组明显高(P<0.05)。术后3d血清PAPPA、IL-6、ICAM-1水平、桡动脉管径是TRA冠状动脉介入术后患者预后的影响因素(P<0.05)。术后桡动脉管径及血清PAPPA、IL-6、ICAM-1联合检测预测TRA冠状动脉介入患者预后的ROC曲线下面积0.892、特异度91.5%,较四者单项检测的高(P<0.05)。结论:TRA冠状动脉介入术后血清PAPPA、IL-6、ICAM-1水平、桡动脉管径可有效反映患者不良预后风险,TRA冠状动脉介入术后为患者实施抗炎治疗对预后的改善有利。

Objective:To explore the changes in radial artery diameter and serum pregnancy-associated plasma protein A(PAPPA),interleukin 6(IL-6)and intercellular adhesion molecule-1(ICAM-1)levels after transradial approach(TRA)coronary intervention,and their clinical significance.Methods:From February 2020 to February 2021,102 patients with coronary heart disease who were admitted to the department of cardiology of our hospital were selected.All patients underwent elective TRA coronary intervention.Serum PAPPA,IL-6 and ICAM-1 levels,and radial artery diameter were measured according to the prognosis,the patients were divided into good prognosis group and poor prognosis group.The prognostic value of serum PAPPA,IL-6 and ICAM-1 levels,and radial artery diameter was analyzed.Results:Compared with pre-operation,serum PAPPA,IL-6,and ICAM-1 levels increased significantly on the 1 day after operation,and significantly decreased on the 3 days after operation.The radial artery diameter successively decreased significantly on the 1 day and 3 days after operation(P<0.05).Of 102 patients undergoing TRA coronary intervention,13.73%had adverse cardiovascular events.The proportion of patients≥60 years old,TC,LDL,postoperative serum PAPPA,IL-6 and ICAM-1 levels,and radial artery diameter in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05).Serum PAPPA,IL-6 and ICAM-1 levels,and radial artery diameter on the 3 days after operation were prognostic factors of patients after TRA coronary intervention(P<0.05).The area under the ROC curve and specificity of combined detection of postoperative radial artery diameter and serum PAPPA,IL-6 and ICAM-1 for prognosis of patients undergoing TRA coronary intervention were 0.892 and 91.5%,higher than those of single index(P<0.05).Conclusion:After TRA coronary intervention,serum PAPPA,IL-6,and ICAM-1 levels,and radial artery diameter can effectively reflect the risk of poor prognosis.Anti-inflammatory treatment for patients after TRA coronary intervention is beneficial to improve the prognosis.