摘要
目的 探索血清蛋白酶激活受体2(PAR-2)水平对冠心病患者经皮冠状动脉介入治疗术(PCI)后支架内再狭窄(ISR)发生的预测价值。方法 连续入选2017年6月至2019年6月间在东南大学附属中大医院心内科首次接受药物洗脱支架植入术治疗的冠心病患者361例。根据PCI术后6~12个月内冠状动脉造影结果是否发生ISR分为ISR组(n=60)和对照组(n=301)。分析PAR-2与冠心病患者PCI术后ISR发生的关系。结果 ISR组患者术前PAR-2水平显著高于对照组[898(547,1063)ng/L比441(351,613)ng/L,P<0.001)];ISR组冠脉病变更严重,表现为Gensini评分明显高于对照组(94.9±39.1比60.6±35.2,P<0.001)。多因素Logistic回归分析显示PAR-2是发生ISR的独立危险因素(OR 1.008,95%CI 1.005~1.010,P<0.001),其他因素包括分叉病变(OR 2.395,95%CI 1.024~5.603,P=0.044)及Gensini评分水平(OR 1.023,95%CI 1.008~1.038,P=0.002)。受试者工作特征曲线分析显示,术前PAR-2预测冠心病患者PCI术后ISR发生的曲线下面积为0.848(95%CI 0.798~0.897,P<0.001)。诊断临界值为799.5 ng/L,其灵敏度为62.5%,特异度为91.7%。结论 PAR-2对冠心病患者PCI术后ISR的发生有一定预测价值,可以作为临床预测ISR的指标。
Objective To explore the predictive value of protease-activated receptor-2(PAR-2)level on the occurrence of in-stent restenosis(ISR)after percutaneous coronary intervention(PCI)in coronary artery disease. Methods A total of 361patient undergoing first drug-eluting stent implantation between Jun 2017 and Jun 2019 in Zhongda Hospital of Southeast University Medical School were continuously enrolled. According to whether ISR occurred within 6-12 months after PCI,the patients were divided into ISR group(n=60)and control group(n=301). The relationship between PAR-2 and ISR after PCI was analyzed in the two groups of patients. Results The levels of PAR-2 in ISR group were significantly increased compared with the control group[898(547,1063)ng/L vs. 441(351,613)ng/L,P<0.001]. The severity of coronary lesions in the ISR group was more serious,represented by a significantly higher Gensini score than the control group(94.9 ± 39.1 vs.60.6 ± 35.2,P < 0.001). Multivariate Logistic regression analysis showed that PAR-2 was an independent risk factor for ISR(OR 1.008,95% CI 1.005~1.010,P<0.001). Other factors included bifurcated lesions(OR 2.395,95% CI 1.024-5.603,P=0.044)and Gensini score(OR 1.023,95% CI 1.008-1.038,P=0.002). The area under the receiver operating characteristic curve for PAR-2 was 0.848,and a PAR-2 of >799.5 ng/L predicted ISR with sensitivity of 62.5% and specificity of 91.7%(95% CI 0.798-0.897,P<0.001). Conclusion PAR-2 has a certain predictive value for the occurrence of ISR in patients after PCI,and can be used as a clinical indicator to predict ISR.
作者
周千星
鄢高亮
刘耀武
朱迪迪
袁春菊
陈龙
马根山
ZHOU Qian-xing;YAN Gao-liang;LIU Yao-wu;ZHU Di-di;YUAN Chun-ju;CHEN Long;MA Gen-shan(Department of Cardiology,Zhongda Hospital of Southeast University Medical School,Nanjing 210009,China)
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2022年第11期920-924,共5页
Chinese Journal of Practical Internal Medicine
基金
国家自然科学基金(81600227)。
