血清视黄醇结合蛋白4与冠状动脉支架植入术后再狭窄的相关性分析  

The association between serum retinol binding protein 4 and in-stent restenosis after percutaneous coronary intervention

作　　者：曹佳齐[1] 丁跃有[1] 郑宏超[1] Cao Jiaqi;Ding Yueyou;Zheng Hongchao(Department of Cardiology,Xuhui District Central Hospital,Shanghai 200030,China)

机构地区：[1]上海市徐汇区中心医院心内科,200030

出　　处：《心脑血管病防治》2020年第1期80-82,共3页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：目的探讨血清视黄醇结合蛋白4(serum retinol binding protein 4,RBP4)与冠状动脉支架植入术(percutaneous coronary intervention,PCI)后再狭窄(in-stent restenosis,ISR)的相关性。方法选取2017年1月至2018年1月间于上海市徐汇区中心医院心内科行PCI术的冠心病患者318例。使用酶免疫试剂盒,测定血清RBP4水平。结果12个月随访结束后,通过冠状动脉造影确认共发生27例ISR(ISR组)。基线数据比较发现,ISR组RBP4水平高于非ISR组(t=7.59,P<0.01),植入支架平均直径低于非ISR组(t=-5.03,P<0.01)。两组间性别、年龄、吸烟比例、高脂血症患病率、高血压患病率、糖尿病患病率、急性冠状动脉综合征发生率、病变血管数、植入支架数、支架平均长度等比较差异均无统计学意义(P>0.05)。ROC分析显示,RBP4对PCI术后ISR预测的最佳临界点为31.23 mg/L。当RBP4为31.23 mg/L时,其预测冠心病患者PCI术后ISR的AUC曲线下面积为0.86,灵敏度为88.9%,特异度为77.31%。多因素COX回归分析发现,血清RBP4水平升高[HR:2.12,95%CI(1.45-2.85)]是冠心病患者PCI术后发生ISR的危险因素,而较大直径的支架[HR:0.88,95%CI(0.79-0.94)]是冠心病患者PCI术后发生ISR的保护因素。结论血清RBP4水平是冠心病患者PCI术后ISR的独立危险因素。Objective To investigate the association between serum retinol binding protein 4(RBP4)and in-stent restenosis(IRS)after percutaneous coronary intervention(PCI).Methods 318 patients with coronary heart disease who underwent PCI in Xuhui District Central Hospital from January 2017 to January 2018 were selected.Serum RBP4 levels were measured by enzyme immunoassay kit.Results After 12-month follow-up,27 patients were diagnosed as ISR according to coronary angiography.The baseline data showed that the RBP4 level in ISR group was higher than that in nonISR group(t=7.59,P<0.01),and the average diameter of stents in ISR group was lower than that in non-ISR group(t=-5.03,P<0.01).There were no significant differences in gender,age,smoking rate,prevalence of hyperlipidemia,hypertension,diabetes,and acute coronary syndrome,number of lesion vessels,number of stents implanted and average length of stents between the two groups.Receiver operate curve suggested that optimal cut-off value of RBP4 for the prediction of ISR was 31.23 mg/L.When RBP4 was 31.23 mg/L,the area under the AUC curve for predicting in-stent restenosis was 0.86,the sensitivity was 88.9%,and the specificity was 77.31%.Multivariate COX regression analysis showed that increased serum RBP4 level[HR:2.12,95%CI(1.45-2.85)],was risk factor for ISR after PCI,while larger diameter stents[HR:0.88,95%CI(0.79-0.94)]were protective factors for ISR after PCI.Conclusion Serum RBP4 level is an independent risk factor for ISR after PCI.

关 键 词：视黄醇结合蛋白 冠状动脉支架植入术 再狭窄 

分 类 号：R654.2[医药卫生—外科学]