esRAGE及sRAGE与冠心病并发糖尿病患者支架内再狭窄的相关性  

Relationship between esRAGE,sRAGE and in-stent restenosis in patients with coronary heart disease complicated with diabetes

作　　者：周静[1] 李飞[1] 高峰[1] 刘哲[1] 曹杰[1] ZHOU Jing;LI Fei;GAO Feng;LIU Zhe;CAO Jie(Department of Cardiovasology,The Affiliated Hospital of Yanan University,Yanan,Shaanxi 716000,China)

机构地区：[1]延安大学附属医院心血管内科,陕西延安716000

出　　处：《岭南心血管病杂志》2018年第6期621-625,共5页South China Journal of Cardiovascular Diseases

基　　金：延安市科学计划项目(项目编号:2017KS-03)

摘　　要：目的研究内源性分泌型糖基化终产物受体(endogenous secretory receptor of advanced glycation endproducts,esRAGE)及可溶性糖基化终产物受体(soluble receptor of advanced glycation end products,sRAGE)与冠状动脉粥样硬化性心脏病(冠心病)并发糖尿病(diabetes mellitus,DM)患者支架内再狭窄(in-stent restenosis,ISR)的相关性。方法入选行药物洗脱支架置入术且术后冠状动脉造影复查确诊为ISR的DM患者(DM-ISR组)36例,选择行药物支架置入术的冠心病并发DM不伴ISR的患者50例为对照组。采用酶联免疫吸附试验(ELISA)方法测定上述患者循环血esRAGE及sRAGE浓度。结果 DM-ISR组血清esRAGE和s RAGE浓度明显低于对照组,差异有统计学意义(P<0.05)。受试者工作特征曲线(receiver operator characteristic curve,ROC)分析结果显示DM-ISR组esRAGE曲线下面积为0.751,sRAGE曲线下面积为0.702。esRAGE浓度均随sRAGE浓度的升高而增加,两者之间呈正相关(r=0.885,P<0.01)。多元直线逐步回归分析结果显示总胆固醇、支架长度、支架直径、脑钠肽、高敏C-反应蛋白(high sensitivity C-reactive protein,hs-CRP)、esRAGE浓度进入方程,脑钠肽(β=0.104,P=0.044),ln(hs-CRP)(β=0.177,P=0.038),esRAGE(β=-0.544,P<0.001)与DM并发ISR独立相关。DM-ISR组血清esRAGE浓度在急性期、亚急性期及慢性期比较,差异均无统计学意义(P<0.05),提示esRAGE浓度对ISR的影响可能始终存在。结论 esRAGE和sRAGE浓度对冠心病并发DM患者ISR发生具有良好的诊断价值,esRAGE及sRAGE浓度减低是冠心病并发DM患者ISR的独立危险因素。Objectives To investigate the correlation between endogenous secretory receptor of advanced glycation end products(esRAGE),soluble receptor of advanced glycation end products(sRAGE)and in-stent restenosis(ISR)in patients with coronary heart disease complicated with diabetes mellitus(DM).Methods A total of36patients with coronary heart disease complicated with DM undergoing drug-eluting stent(DES)implantation were selected as the research objects.According to the postoperative review of coronary angiography,the patients were divided into two groups:coronary heart disease complicated with DM patients with ISR were in DM-ISR group(n=36)and coronary heart disease complicated with DM patients without ISR were in control group(n=50).Serum concentrations of esRAGE and sRAGE were measured by enzyme linked immunosorbent assay.Results Serum concentrations of esRAGE and sRAGE in DM-ISR group were significantly lower than those of control group(P<0.05).Receiver operator characteristic curve(ROC)analysis showed that in DM-ISR group,for esRAGE,area under the curve was0.751;for sRAGE,area under the curve was0.702.Serum concentration of esRAGE increased with the rise of sRAGE.Serum concentration of esRAGE and sRAGE positively correlated(r=0.885,P<0.01)with each other.Results of multiple linear stepwise regression analysis showed that total cholesterol,stent length,stent diameter,brain natriuretic peptide(BNP),high sensitivity C-reactive protein(hs-CRP),esRAGE were in the equation,among which BNP(β=0.104,P=0.044),ln(hs-CRP)(β=0.177,P=0.038),esRAGE(β=-0.544,P<0.001)independently associated with DM-ISR.Serum concentration of esRAGE in acute,subacute and chronic phase had no statistical significance(P<0.05)in DM-ISR group,suggesting that the influence of serum concentration of esRAGE on ISR might always exist.Conclusions Serum concentrations of esRAGE,sRAGE have diagnostic value on patients with coronary heart disease complicated with DM,meanwhile,decreasing serum concentrations of esRAGE and sRAGE are risk factors for patients w

关 键 词：冠状动脉疾病 内源性分泌型糖基化终产物受体 可溶性糖基化终产物受体 糖尿病 支架内再狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]