血清鸢尾素、Metrnl水平与PCI术后支架内再狭窄的相关性研究

Correlation between serum irisin,Metrnl levels and in-stent restenosis after PCI

目的 研究血清鸢尾素、镍纹蛋白样蛋白(Metrnl)水平与经皮冠状动脉支架介入术(PCI)术后发生支架内再狭窄(ISR)的相关性。方法 选取2021年10月至2023年3月潍坊市人民医院收治住院、行PCI术且使用第二代药物洗脱支架的257例冠状动脉粥样硬化性心脏病(冠心病)患者作为研究对象,术后发生ISR的47例纳入ISR组,未发生ISR的210例纳入非ISR组。选取同期医院体检健康者50例作为健康对照组。收集并分析患者临床资料,采用ELISA法检测血清鸢尾素、Metrnl水平,logistic回归分析PCI术后发生ISR的影响因素,受试者工作特征(ROC)曲线分析鸢尾素、Metrnl水平对PCI术后发生ISR的预测价值。结果 ISR组鸢尾素、Metrnl水平低于非ISR组和健康对照组,且非ISR组鸢尾素、Metrnl水平低于健康对照组,差异均有统计学意义(P<0.05)。Metrnl与鸢尾素水平呈正相关(r=0.768,P<0.001)。ISR组与非ISR组糖尿病史、吸烟史、二磷酸腺苷(ADP)抑制率、支架总长度比较,差异有统计学意义(P<0.05)。D-二聚体水平升高是ISR的危险因素,而鸢尾素、Metrnl水平、ADP抑制率、直接胆红素升高是ISR的保护因素(P<0.05)。结论 鸢尾素、Metrnl水平降低的冠心病患者PCI术后易发生ISR,两者联合检测对PCI术后发生ISR有一定预测价值。

Objective To study the correlation between serum irisin,nickel striated protein-like protein(Metrnl)levels and in-stent restenosis(ISR)after percutaneous coronary intervention(PCI).Methods From October 2021 to March 2023,a total of 257 patients with coronary artery disease who were hospitalized in Weifang People’s Hospital,underwent PCI and used the second-generation drug-eluting stent were selected as subjects.Among them,47 patients with ISR were included in the ISR group,and 210 patients without ISR were included in the non-ISR group.A total of 50 healthy people who underwent physical examination in the hospital during the same period were selected as the healthy control group.The clinical data of patients were collected and analyzed.The levels of serum irisin and Metrnl were detected by ELISA.The influencing factors of ISR after PCI were analyzed by logistic regression.The predictive value of irisin and Metrnl levels on ISR after PCI was analyzed by receiver operating characteristic(ROC)curve.Results The levels of irisin and Metrnl in the ISR group were lower than those in the non-ISR group and healthy control group,the levels of irisin and Metrnl in the non-ISR group were lower than those in the healthy control group,and the differences were statistically significant(P<0.05).The Metrnl level was positively correlated with irisin level(r=0.768,P<0.001).There were significant differences in diabetes history,smoking history,adenosine diphosphate(ADP)inhibition rate,total stent length between the ISR group and non-ISR group(P<0.05).Elevated D-dimer level was a risk factor for ISR,while irisin,Metrnl levels,ADP inhibition rate and direct bilirubin were protective factors for ISR(P<0.05).Conclusion Coronary heart disease patients with decreased levels of irisin and Metrnl are prone to ISR after PCI.The combined detection of irisin and Metrnl has a certain predictive value for ISR after PCI.