血清可溶性细胞间黏附分子1、可溶性CD163水平与不稳定型心绞痛患者经皮冠脉介入术后支架内再狭窄的关系

Relationship between serum soluble intercellular adhesion molecule-1,soluble CD163 levels and in-stent restenosis after percutaneous coronary intervention in patients with unstable angina pectoris

目的探讨血清可溶性细胞间黏附分子1(sICAM-1)、可溶性CD163(sCD163)水平与不稳定型心绞痛(UAP)患者经皮冠脉介入术(PCI)后支架内再狭窄(ISR)的关系。方法选取2019年1月至2021年2月江苏省泰州市中医院收治的182例行PCI的UAP患者,根据是否发生ISR将其分为ISR组(41例)和非ISR组(141例)。收集两组临床资料,采用酶联免疫吸附试验检测其血清sICAM-1、sCD163水平。采用二元logistic回归分析UAP患者PCI后发生ISR的影响因素,采用受试者操作特征(ROC)曲线分析血清sICAM-1、sCD163水平对UAP患者PCI后ISR发生的预测价值。结果ISR组血清sICAM-1、sCD163、低密度脂蛋白胆固醇(LDL-C)水平高于非ISR组,支架长度长于非ISR组,支架内径短于非ISR组(P<0.05)。多因素分析结果显示,支架内径(OR=0.877,95%CI:0.797~0.965)、LDL-C(OR=1.006,95%CI:1.003~1.009)、sICAM-1(OR=1.014,95%CI:1.006~1.023)、sCD163(OR=1.121,95%CI:1.021~1.232)为UAP患者PCI后发生ISR的独立影响因素(P<0.05)。ROC曲线分析结果显示,血清sICAM-1、sCD163联合预测UAP患者PCI后ISR的曲线下面积高于各指标单独预测(P<0.05)。结论血清sICAM-1、sCD163水平是UAP患者PCI后发生ISR的独立影响因素,可作为ISR的预测指标。

Objective To investigate the relationship between serum soluble intercellular adhesion molecule-1(sICAM-1),soluble CD163(sCD163)levels and in-stent restenosis(ISR)after percutaneous coronary intervention(PCI)in patients with unstable angina pectoris(UAP).Methods A total of 182 UAP patients who underwent PCI in Taizhou Hospital of Traditional Chinese Medicine,Jiangsu Province from January 2019 to February 2021 were selected and divided into ISR group(41 cases)and non-ISR group(141 cases)according to whether ISR occurred.The clinical data of the two groups were collected,and the serum levels of sICAM-1 and sCD163 were detected by enzyme-linked immunosorbent assay.Binary logistic regression was used to analyze the influencing factors of ISR in UAP patients after PCI.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum sICAM-1 and sCD163 levels for ISR in UAP patients after PCI.Results The levels of serum sICAM-1,sCD163,and low-density lipoprotein cholesterol(LDL-C)in the ISR group were higher than those in the non-ISR group,the stent length was longer than that in the non-ISR group,and the stent diameter was shorter than that in the non-ISR group(P<0.05).Multivariate analysis showed that stent diameter(OR=0.877,95%CI:0.797-0.965),LDL-C(OR=1.006,95%CI:1.003-1.009),sICAM-1(OR=1.014,95%CI:1.006-1.023),and sCD163(OR=1.121,95%CI:1.021-1.232)were independent influencing factors for ISR in UAP patients after PCI(P<0.05).The results of ROC curve analysis showed that the area under the curve of serum sICAM-1 and sCD163 combined to predict ISR in UAP patients after PCI was higher than that of each index alone(P<0.05).Conclusion Serum sICAM-1 and sCD163 levels are independent influencing factors of ISR in UAP patients after PCI,which can be used as predictors of ISR.