超敏C反应蛋白与白蛋白比值对冠状动脉支架内再狭窄的预测价值

Prediction value of hypersensitive C-reactive protein to albumin ratio in in-stent restenosis after percutaneous coronary inter-vention

目的探讨超敏C反应蛋白(hs-CRP)与白蛋白(ALB)比值(hs-CRP/ALB)对冠状动脉支架内再狭窄(ISR)的预测价值。方法回顾性分析2019年1月至2022年1月在浙江绿城心血管医院成功置入支架并自愿接受随访的冠心病患者187例。术后随访6个月至1年,再次行冠状动脉造影术,根据是否发生ISR,将患者分为ISR组30例及无ISR组157例。采用单因素及多因素logistic回归分析经皮冠状动脉介入治疗(PCI)术后发生ISR的相关影响因素,采用ROC曲线分析hs-CRP/ALB、中性粒细胞与淋巴细胞比值(NLR)、支架长度对PCI术后发生ISR的预测价值。结果ISR组患者术前hs-CRP/ALB、NLR及支架长度均高于对照组,差异均有统计学意义(均P<0.05),且为ISR的独立影响因素(均P<0.05)。ROC曲线显示,hs-CRP/ALB、NLR、支架长度预测ISR风险的AUC分别为0.755、0.605、0.626,截断值分别为0.249、2.069、24.000,灵敏度分别为0.633、0.800、0.633,特异度分别为0.885、0.452、0.573。结论hs-CRP/ALB、NLR、支架长度与冠心病患者发生ISR有关,有望成为潜在预测因子。

Objective To investigate the predictive value and clinical significance of ratio of high sensitivity C reactive protein(hs-CRP)to albumin(ALB)(hs-CRP/ALB)in in-stent restenosis(ISR).Methods A retrospective analysis was performed on 187 patients with coronary heart disease who received stent implantation in Zhejiang Greentown Cardiovascular Hospital from January 2019 to January 2022.Coronary angiography(CAG)was performed again 6 months to 1 years after the operation.Patients were divided into an ISR group(30 cases)and a non-ISR group(157 cases)according to the presence or absence of ISR.Univariate and multivariate logistic regression were used to analyze factors correlated with ISR after percutaneous coronary intervention(PCI),and ROC curve was used to analyze the predictive value of hs-CRP/ALB,neutrophil to lymphocyte ratio(NLR),and stent length on ISR after PCI.Results Before operation,hs-CRP/ALB,NLR and stent length in the ISR group were all significantly higher or larger than those of the control group(all P<0.05),and they were independent risk factors for coronary ISR.The ROC curve showed that the AUC of hs-CRP/ALB,NLR and stent length in predicting ISR risk were 0.755,0.605,and 0.626,respectively,with the cut-off values of respective 0.249,2.069,and 24,the sensitivity of respective 63.33%,80.00%,and 63.33%,and the specificity of 88.54%,45.22%,and 57.32%,respectively.Conclusion Hs-CRP/ALB,NLR and stent length are associated with ISR in patients with coronary heart disease,and are expected to be potential prodictors.