血清HDAC3、CysC与冠心病患者介入治疗后支架内再狭窄的关系

Relationship among serum HDAC3,CysC levels and in-stent restenosis in patients with coronary heart disease after interventional therapy

目的:探讨经皮冠状动脉介入治疗(PCI)患者血清组蛋白去乙酰化酶3(HDAC3)、胱抑素C(CysC)水平与支架内再狭窄(ISR)发生的关系。方法:我院接受PCI治疗,随访1年的97例冠心病患者,根据ISR发生情况被分为发生ISR组(31例)与未发生ISR组(66例)。比较两组一般资料及HDAC3、CysC水平,并分析血清HDAC3、CysC水平与冠心病患者PCI后发生ISR的关系。结果:PCI后随访1年,97例患者中31例发生ISR,占比31.96%。与未发生ISR组比较,发生ISR组规律服用抗血小板药物比例及血清CysC水平显著降低,血清CRP及HDAC3水平显著升高,P均<0.01;二元Logistic回归分析显示,C反应蛋白(CRP)、HDAC3水平是冠心病患者PCI后ISR发生的独立危险因素(OR=2.037、23.560,P均<0.01),CysC水平是其独立保护因子(OR=0.005,P=0.036);ROC曲线显示,入院时血清CysC、HDAC3水平预测冠心病PCI患者ISR发生风险的曲线下面积(AUC)分别为0.728、0.801,预测价值较理想。结论:高HDAC3水平、低CysC水平提示冠心病PCI患者有发生ISR高风险,二者用于预测ISR发生有一定的价值。

Objective:To explore the relationship among serum levels of serum histone deacetylase 3(HDAC3),cystatin C(CysC)and in-stent restenosis(ISR)in patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods:A total of 97 CHD patients treated in our hospital undergoing PCI were followed up for one year.According to occurrence of ISR,they were divided into ISR group(n=31)and no ISR group(n=66).General data,serum levels of HDAC3 and CysC were compared between two groups.Relationship among serum levels of HDAC3,CysC and ISR in CHD patients after PCI were analyzed.Results:On one year after PCI,ISR occurred in 31 cases(31/97,31.96%).Compared with no ISR group,there were significant reductions in percentage of regular antiplatelet drug administration and serum CysC level,and significant rise in serum levels of CRP and HDAC3 in ISR group,P<0.01 all;binary Logistic regression analysis indicated that CRP and HDAC3 levels were independent risk factors for ISR in CHD patients after PCI(OR=2.037,23.560,P<0.01 both),while CysC was its independent protective factor(OR=0.005,P=0.036);ROC curve indicated that area under curve(AUC)of serum levels of CysC and HDAC3 predicting ISR risk in these patients was 0.750,0.801 respectively,and the predictive value was more ideal.Conclusion:High HDAC3 level and low CysC level may suggest high ISR risk in CHD patients after PCI,they possess certain value in predicting ISR.