摘要
目的探讨经皮冠状动脉介入治疗（PCI）后患者血清骨桥蛋白（OPN）水平对支架内再狭窄（ISR）的预测价值。方法收集我院接受PCI后随访1年、复查冠状动脉造影检查的患者120例,其中男68例,女52例,平均年龄为59.38±11.13岁。根据冠状动脉造影结果分为再狭窄组和无再狭窄组,复查冠状动脉造影时检测两组患者血清OPN等生物化学指标,比较两组临床资料、OPN等生物化学指标水平。结果再狭窄组患者血清OPN水平显著高于无再狭窄组,差异有统计学意义（4.79±1.09μg/L比3.11±1.13μg/L,P〈0.01）。Logistic多因素回归分析显示,OPN升高是PCI后ISR发生的独立危险因素（OR=3.034,95%CI为1.532~6.007,P〈0.01）。在OPN预测ISR能力的ROC曲线中,其曲线下面积为0.872,95%CI为0.770~0.975,P〈0.01;当OPN取4.16μg/L时,其阳性预测价值为56.5%,阴性预测价值为95.9%,敏感性为76.5%,特异性为89.3%,准确性为88.3%。结论 PCI后患者血清OPN水平与ISR密切相关,血清OPN的水平对ISR的发生具有一定的预测价值,尤其是其阴性预测价值高。
Aim To explore the predictive value of serum osteopontin（ OPN） level on in-stent restenosis（ ISR）after percutaneous coronary intervention（ PCI）. Methods A total of 120 patients（ 68 males and 52 females） with acute coronary syndrome or stable angina pectoris successfully treated with PCI were collected,who were followed-up for 1year and reexamined with coronary angiography（ CAG）. The average age of the patients was 59. 38 ± 11. 13. According to the results of CAG,study subjects were divided into ISR group and non-ISR group. Clinical data,serum OPN and other biochemical patameters were analyzed and compared between two groups. Results The level of serum OPN was significantly higher in ISR group than that in non-ISR group（ 4. 79 ± 1. 09 μg / L vs 3. 11 ± 1. 13 μg / L,P〈 0. 01）. Multivariate Logistic regression analysis revealed that high serum OPN was an independent risk factor of ISR（ OR = 3. 034,95%CI： 1. 532 ~ 6. 007,P〈 0. 01）. Area under the receiver operating characteristic curve（ ROC） for OPN in evaluating prognosis of ISR patients was 0. 872（ 95% CI： 0. 770 ~ 0. 975,P〈 0. 01）. The optimal cut-off value of OPN was 4. 16μg /L,at that point,the positive predictive rate for ISR was 56. 5%,negative rate was 95. 9%,sensitivity was 76. 5%,specificity was 89. 3%,and accuracy was 88. 3%. Conclusions Serum OPN level is closely related with ISR after PCI. It has a certain predictive value for the occurrence of ISR,and its negative rate is especially high.
出处
《中国动脉硬化杂志》
CAS
北大核心
2015年第9期911-914,共4页
Chinese Journal of Arteriosclerosis
基金
辽宁省高等学校创新团队项目(LT2012016)
