血清VEGF、G-CSF、sTREM-1与急性心肌梗死患者PCI术后支架内再狭窄的相关性研究

Correlation between Serum VEGF,G-CSF,sTREM-1 and Stent Restenosis in Patients with Acute Myocardial Infarction after PCI

目的探讨血清血管内皮生长因子(VEGF)、粒细胞集落刺激因子(G-CSF)、可溶性髓系细胞触发受体-1(sTREM-1)与急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后支架内再狭窄(ISR)的关系。方法选取商丘市第一人民医院2020年2月—2021年3月行PCI术治疗且完成随访的100例AMI患者为研究对象,根据PCI术后12个月造影复查结果分为ISR组(n=24,支架内狭窄程度≥50%)和非ISR组(n=76,支架内狭窄程度<50%)。比较两组一般临床资料、术后1 d及7 d血清VEGF、G-CSF、sTREM-1水平,Logisitc回归分析影响ISR发生的危险因素,以及各指标不同水平对发生ISR的危险度。结果ISR组糖尿病率、冠状动脉多支病变率较非ISR组高(P<0.05);ISR组术后1 d、7 d血清VEGF、G-CSF较非ISR组低,sTREM-1水平较非ISR组高(P<0.05);Logistic回归分析显示,糖尿病、冠状动脉病变支数、术后1 d及7 d血清VEGF、G-CSF、sTREM-1水平均是影响AMI患者PCI术后发生ISR的因素(P<0.05);术后1 d、7 d,血清VEGF、G-CSF、sTREM-1高水平患者发生ISR的危险度均较低水平者高。结论监测AMI患者PCI术后血清VEGF、G-CSF、sTREM-1表达水平对预测ISR发生具有一定价值。

Objective To investigate the relationship between serum vascular endothelial growth factor(VEGF),granulocyte colony-stimulating factor(G-CSF),soluble myeloid cell triggering receptor-1(sTREM-1)and intrastent restenosis(ISR)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods 100 patients with AMI who underwent PCI in Shangqiu First People's Hospital from February 2020 to March 2021 and completed follow-up were selected as the study objects,and were divided into ISR group(n=24,with intrastent stenosis≥50%)and non-ISR group(n=76,intrastent stenosis<50%)according to the results of angiographic review 12 months after PCI.General clinical data,serum levels of VEGF,G-CSF and sTREM-1,and Logisitc regression analysis of risk factors affecting the occurrence of ISR were compared between the two groups,as well as the risk of ISR with different levels of each index.Results The rate of diabetes mellitus and coronary artery multivessel disease in ISR group was higher than that in non-ISR group(P<0.05).Serum VEGF and G-CSF in ISR group were lower than those in non-ISR group 1 d and 7 d after surgery,and sTREM-1 level was higher than that in non-ISR group(P<0.05).Logistic regression analysis showed that diabetes mellitus,number of coronary artery lesions,serum VEGF,G-CSF and sTREM-1 levels 1 and 7 days after surgery were all factors influencing the occurrence of ISR in AMI patients after PCI(P<0.05).The risk of ISR was higher in patients with high levels of serum VEGF,G-CSF and sTREM-1 than in patients with low levels 1 and 7 days after surgery.Conclusion Monitoring the expression levels of serum VEGF,G-CSF and sTREM-1 in AMI patients after PCI is valuable for predicting the occurrence of ISR.