CTRP3、糖基化ApoA-I水平与冠心病患者PCI术后心血管终点事件的关系研究

Relationship between CTRP3,glycosylated ApoA-I level and cardiovascular endpoint events in patients with coronary heart disease after PCI

目的探究补体C1q肿瘤坏死因子相关蛋白3(CTRP3)、糖基化糖基化载脂蛋白A-I(gly-ApoA-I)水平与冠心病患者经皮冠状动脉介入(PCI)术后心血管终点事件的关系研究。方法选取2020年6月至2023年2月广州医科大学附属中医医院收治的145例T2DM患者,患者均行PCI术,术后随访6个月,根据血管终点事件的发生情况分为发生组(n=91)及未发生组(n=54)。检测并比较两组患者CTRP3、gly-ApoA-I水平及临床资料,采用Logistic回归分析法明确影响PCI术后心血管终点事件的危险因素,并绘制受试者工作特征曲线(ROC)分析CTRP3、gly-ApoA-I对PCI术后心血管终点事件的预测价值。结果145例进行PCI的冠心病患者,随访1年,其中54例发生心血管终点事件,发生率为37.24%;发生组患者血清CTRP3水平低于未发生组、gly-ApoA-I水平高于未发生组(P<0.05);发生组合并糖尿病占比、NYHA分级Ⅱ~Ⅲ级占比、多支病变占比及LDL-C水平均高于未发生组(P<0.05);Logisitc回归分析显示,合并糖尿病、NYHA分级Ⅱ~Ⅲ级、多支病变、CTRP3低水平及gly-ApoA-I高水平均是导致PCI术后心血管终点事件的独立危险因素(P<0.05)。ROC结果显示,血清CTRP3、gly-ApoA-I单独及联合预测PCI术后心血管终点事件的AUC(95%CI)分别为0.764(0.686~0.831)、0.732(0.652~0.802)、0.878(0.814~0.927),二者联合用于PCI术后心血管终点事件的预测效能优于各指标单独检测(Z=2.230、2.732,P<0.05)。结论冠心病PCI术后发生心血管终点事件患者血清CTRP3水平降低,gly-ApoA-I水平升高,且二者为心血管终点事件的独立危险因素,联合使用心血管终点事件发生的预测价值更高。

Objective To investigate the relationship between the levels of complement C1q tumor necrosis factor-associated protein 3(CTRP3)and glycoglyated apolipoprotein A-I(gly-ApoA-I)and cardiovascular endpoint events in patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods 145 T2DM patients admitted to the hospital from June 2020 to February 2023 were selected.All patients underwent PCI and were followed up for 6 months.According to the occurrence of vascular endpoint events,they were divided into occurrence group(n=91)and non-occurrence group(n=54).The levels of CTRP3,gly-ApoA-I and clinical data of the two groups were detected and compared.Logistic regression analysis was used to identify the risk factors affecting cardiovascular endpoint events after PCI.Receiver operating characteristic curve(ROC)was drawn to analyze the predictive value of CTRP3 and gly-ApoA-I on cardiovascular endpoint events after PCI.Results Of 145 patients with coronary heart disease who underwent PCI and were followed up for 1 year,54 had cardiovascular endpoint events(37.24%).The serum CTRP3 level in the group with occurrence was lower than that in the group without occurrence,and the level of gly-ApoA-I was higher than that in the group without occurrence(P<0.05).The proportion of diabetes mellitus,the proportion of NYHA gradeⅡtoⅢ,the proportion of multi-branch lesions and the level of LDL-C were higher than those in the non-occurrence group(P<0.05).Logisitc regression analysis showed that combined diabetes mellitus,NYHA classⅡtoⅢ,multi-vessel disease,low level of CTRP3 and high level of gly-ApoA-I were independent risk factors for cardiovascular endpoint events after PCI(P<0.05).ROC results showed that the AUC(95%CI)of serum CTRP3 and gly-ApoA-I alone and in combination were 0.764(0.686~0.831),0.732(0.652~0.802),0.878(0.814~0.927)for predicting cardiovascular endpoint events after PCI,respectively.The predictive efficacy of the combination of the two methods for cardiovascular endpoint events after PCI was better than that of each indicator alone(Z=2.230,2.732,P<0.05).Conclusion Serum CTRP3 level is decreased and gly-ApoA-I level is increased in patients with cardiovascular end events after PCI,and the two are independent risk factors for cardiovascular end events,and the combined use of cardiovascular end events has higher predictive value.