血清二肽基肽酶4水平与冠状动脉支架内再狭窄的相关性分析

Correlation analysis between serum DPP4 level and coronary in-stent restenosis

目的探讨血清二肽基肽酶4(DPP4)水平与冠状动脉粥样硬化性心脏病(CAD)病人冠状动脉支架内再狭窄(ISR)的关系。方法选取2017年1月至2021年1月于河北中石油中心医院行经皮冠状动脉介入(PCI)术的220例CAD病人为研究对象,根据CAD病人PCI术后1年内是否发生ISR将其分为无ISR组(n=188)和ISR组(n=32)。比较ISR组、无ISR组一般资料及血清DPP4、C反应蛋白(CRP)水平;分析CAD病人PCI术后发生ISR的影响因素;分析血清DPP4、CRP对CAD病人PCI术后发生ISR的预测价值。结果ISR组CAD病人支架直径小于无ISR组[(2.82±0.46)mm比(3.38±0.51)mm,P<0.05],支架长度长于无ISR组[(25.85±3.21)mm比(23.43±3.15)mm,P<0.05];ISR组CAD病人血清DPP4、CRP水平高于无ISR组(P<0.05);支架直径是CAD病人PCI术后发生ISR的保护因素(P<0.05),支架长度、DPP4、CRP是CAD病人PCI术后发生ISR的危险因素(P<0.05);血清DPP4、CRP预测CAD病人PCI术后发生ISR的曲线下面积(AUC)分别为0.87、0.70,其截断值分别为11.89 ng/L、15.37 mg/L,灵敏度分别为81.3%、75.0%,特异度分别为89.4%、54.7%。结论DPP4在行PCI术后发生ISR的CAD病人血清中水平较高,DPP4有望作为预测CAD病人PCI术后发生ISR的血清标志物。

Objective To investigate the relationship between serum dipeptidyl peptidase 4(DPP4)level and coronary in-stent restenosis(ISR)in patients with coronary atherosclerotic heart disease(CAD).Methods A total of 220 CAD patients who underwent percutaneous coronary intervention(PCI)in Hebei CNPC Central Hospital from January 2017 to January 2021 were regarded as the research subjects.According to whether the CAD patients had ISR within 1 year after PCI,they were assigned into the non-ISR group(n=188)and ISR group(n=32).The general data,serum DPP4 and C-reactive protein(CRP)levels between the ISR group and the non-ISR group were compared;the influencing factors of ISR in CAD patients after PCI were analyzed;and the predictive value of serum DPP4 and CRP for ISR in patients with CAD after PCI was analyzed.Results The stent diameter of CAD patients in the ISR group was smaller than that in the non-ISR group[(2.82±0.46)mm vs.(3.38±0.51)mm,P<0.05],and the stent length in the ISR group was longer than that in the non-ISR group[(25.85±3.21)mm vs.(23.43±3.15)mm,P<0.05];the levels of serum DPP4 and CRP in CAD patients in the ISR group were higher than those in the non-ISR group(P<0.05);stent diameter was a protective factor for ISR in CAD patients after PCI(P<0.05),and stent length,DPP4 and CRP were risk factors for ISR in CAD patients after PCI(P<0.05);the areas under the curve(AUC)of serum DPP4 and CRP in predicting ISR in CAD patients after PCI were 0.87 and 0.70,respectively,the cut-off values were 11.89 ng/L and 15.37 mg/L,respectively,the sensitivities were 81.3%and 75.0%,respectively,and the specificities were 89.4%and 54.7%,respectively.Conclusion The serum level of DPP4 is higher in CAD patients with ISR after PCI,and DPP4 is expected to be used as a serum marker to predict the occurrence of ISR in CAD patients after PCI.