成纤维细胞生长因子23与冠状动脉支架内再狭窄的相关性分析

Correlation between fibroblast growth factor 23 and coronary in-stent restenosis

目的 探讨成纤维细胞生长因子23(fibroblast growth factor 23,FGF23)与冠状动脉支架内再狭窄的相关性。方法 选取2020年1月~2021年12月西部战区总医院心血管内科复查冠状动脉造影患者221例,按照是否存在支架内再狭窄分为再狭窄组99例和无再狭窄组122例。比较2组一般临床资料和FGF23水平,采用logistic回归分析FGF23水平与支架内再狭窄风险的关系,用ROC曲线分析血清FGF23水平对支架内再狭窄的诊断价值。结果 与无再狭窄组比较,再狭窄组糖尿病、吸烟、LDL-C、TC、空腹血糖、支架总数、支架置入时间、因胸痛复查造影和FGF23水平明显升高,差异有统计学意义(P<0.05,P<0.01)。Pearson相关性分析显示,FGF23、支架总数、LDL-C、TC与支架内再狭窄呈正相关(P<0.05,P<0.01)。多因素logistic回归分析显示,FGF23、支架总数与支架内再狭窄独立相关(OR=1.844,95%CI:1.318~2.794,P=0.028;OR=1.504,95%CI:1.080~2.095,P=0.016)。ROC曲线分析显示,血清FGF23诊断冠状动脉支架内再狭窄的曲线下面积为0.715,最佳诊断界值为212.4 ng/L,敏感性为66.7%,特异性为73.5%(P=0.003)。结论 血清FGF23水平升高与支架内再狭窄独立相关,且FGF23水平对支架内再狭窄具有一定的诊断价值。

Objective To investigate the correlation of fibroblast growth factor 23(FGF23) and in-stent restenosis in coronary arteries.Methods A total of 221 patients undergoing re-examination of coronary angiography in the Cardiology Department of General Hospital of Western Theater Command from January 2020 to December 2021 were recruited in this study.According to the exi-stence of coronary in-stent restenosis or not, the patients were divided into restenosis group(n=99) and non-restenosis group(n=122).The general clinical data and FGF23 level were compared between the 2 groups.Logistic regression analysis was used to explore the relationship between FGF23 level and risk for in-stent restenosis.ROC curve was drawn to test the diagnostic value of serum FGF23 level for in-stent restenosis.Results Compared with the non-restenosis group, the restenosis group had significantly higher smoking rate, diabetes prevalence, LDL-C,TC and fasting blood glucose levels, total number of stents implanted, time of stent implantation, review of angiography due to chest pain and FGF23 level(P<0.05,P<0.01).Pearson correlation analysis showed that FGF23,total number of stents, LDL-C,and TC were positively correlated with in-stent restenosis(P<0.05,P<0.01).Multivariate logistic regression analysis indicated that FGF23 level and total number of stents implanted were independently associated with in-stent restenosis(OR=1.844,95%CI:1.318-2.794,P=0.028;OR=1.504,95%CI:1.080-2.095,P=0.016).The area under the curve of FGF23 for the diagnosis of in-stent restenosis was 0.715,with an optimal diagnostic cut-off value of 212.4 ng/L,a sensitivity of 66.7% and a specificity of 73.5%(P=0.003).Conclusion Serum FGF23 level is independently associated with in-stent restenosis, and its level has certain diagnostic value for coronary in-stent restenosis.