血清脂联素和分泌型卷曲蛋白5水平与冠状动脉支架植入术后再狭窄的相关性分析  

Correlations of serum adiponectin and SFRP5 levels with restenosis after coronary artery stent implantation

作　　者：魏华[1] 倪企春 陈静[1] 李娟[2] 韦武 WEI Hua;NI Qichun;CHEN Jing;LI Juan;WEI Wu(Department of Cardiovascular Medicine,Hami Central Hospital Affiliated to Xinjiang Medical University,Hami 839000,China;Intervention Center,Hami Central Hospital Affiliated to Xinjiang Medical University,Hami 839000,China)

机构地区：[1]新疆医科大学附属哈密市中心医院心血管内科,新疆维吾尔自治区哈密839000 [2]新疆医科大学附属哈密市中心医院介入中心,新疆维吾尔自治区哈密839000

出　　处：《中华实用诊断与治疗杂志》2020年第8期818-821,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：新疆维吾尔自治区自然科学基金(2017D01C280)。

摘　　要：目的探讨急性心肌梗死经冠状动脉支架植入术治疗后再狭窄患者血清脂联素(adiponectin, APN)和分泌型卷曲蛋白5(secreted frizzled related protein 5, SFRP5)水平及其对预测再狭窄的价值。方法接受冠状动脉支架植入术治疗的急性心肌梗死患者110例,术后9个月均行冠状动脉造影检查,其中冠状动脉再狭窄者13例为再狭窄组,未发生再狭窄者97例为未再狭窄组;同期体检健康者40例为对照组。检测再狭窄组、未再狭窄组支架植入术前、术后3 d、术后9个月时血清APN、SFRP5水平,并与对照组血清APN与SFRP5水平进行比较。采用多因素logistic回归分析急性心肌梗死患者冠状动脉植入术后发生再狭窄的影响因素;绘制ROC曲线,评估各时间点血清APN、SFRP5水平预测急性心肌梗死患者冠状动脉支架植入术治疗后发生再狭窄的价值。结果支架植入术前,血清APN、SFRP5水平再狭窄组[(18.21±3.02)、(35.24±4.02)μg/L]和未再狭窄组[(22.11±2.21)、(40.22±5.11)μg/L]低于对照组[(25.45±3.12)、(52.14±4.11)μg/L](P<0.05),再狭窄组低于未再狭窄组(P<0.05);术后3 d和术后9个月,再狭窄组血清APN[(15.02±3.33)、(12.02±2.29)μg/L]和SFRP5[(30.34±3.33)、(22.17±5.12)μg/L]水平低于未再狭窄组[(21.78±3.02)、(20.21±2.33)μg/L,(38.32±4.12)、(35.45±4.07)μg/L](P<0.05);冠状动脉支架植入患者血清APN水平与SFRP5水平呈正相关(r=0.662,P<0.001);血清APN、SFRP5水平是急性心肌梗死患者冠状动脉支架植入术后发生再狭窄的影响因素(OR=4.721,95%CI:3.400~7.674,P<0.001;OR=3.772,95%CI:2.667~6.894,P=0.001);支架植入术前、术后3 d和术后9个月,血清APN、SFRP5水平预测冠状动脉支架植入术后发生再狭窄的AUC均>0.8,均有较好的预测价值,其中术后3 d的预测价值最好。结论血清APN、SFRP5低表达对急性心肌梗死患者冠状动脉支架植入术后发生再狭窄有一定预测价值。Objective To investigate the levels of serum adiponectin(APN) and secreted frizzled related protein 5(SFRP5) and their values to the prediction of restenosis after coronary artery stent implantation in patients with acute myocardial infarction. Methods Totally 110 patients with acute myocardial infarction undergoing coronary artery stent implantation were divided into restenosis group(n=13) and no-restenosis group(n=97) according to the results of coronary angiography in postoperative 9 months, and another 40 healthy volunteers were as controls(control group). The levels of serum APN and SFRP5 were detected before operation, on the 3 rd postoperative day and in 9 months after operation in restenosis group and no-restenosis group, which were compared with control group. Multivariate logistic regression was used to analyze the influencing factors for restenosis after coronary artery stent implantation in cute myocardial infaction patients. ROC was drawn to evaluate the values of APN and SFRP5 to the prediction of restenosis after operation. Results Before stent implantation, the levels of serum APN and SFRP5 were lower in restenosis group((18.21±3.02),(35.24±4.02) μg/L) and no-restenosis group((22.11±2.21),(40.22±5.11) μg/L) than those in control group((25.45±3.12),(52.14±4.11) μg/L)(P<0.05), and in restenosis group than those in no-restenosis group(P<0.05). On the 3 rd postoperative day and in 9 months after operation, the levels of serum APN and SFRP5 were lower in restenosis group(APN:(15.02±3.33),(12.02±2.29) μg/L;SFRP5:(30.34±3.33),(22.17±5.12)μg/L)than those in no-restenosis group(APN:(21.78±3.02),(20.21±2.33)μg/L;SFRP5:(38.32±4.12),(35.45±4.07)μg/L)(P<0.05).Serum APN level was positively correlated with SFRP5 level(r=0.662,P<0.001)in patients undergoing coronary stent implantation.The serum APN and SFRP5 levels were the influencing factors for restenosis after coronary stent implantation(OR=4.721,95%CI:3.400-7.674,P<0.001;OR=3.772,95%CI:2.667-6.894,P=0.001).Before stent implantation,on t

关 键 词：急性心肌梗死 冠状动脉支架植入术 再狭窄 脂联素 分泌型卷曲蛋白5 

分 类 号：R541.4[医药卫生—心血管疾病]