冠心病患者介入术后中性粒细胞外诱捕网水平与支架内再狭窄的相关性分析  

Correlation between neutrophil trapping nets levels and stent restenosis in patients with coronary heart disease after percutaneous coronary intervention

作　　者：陈晓琴[1] 高敏雁 丁雪茹[1] 周欣荣[1] CHEN Xiaoqin;GAO Minyan;DING Xueru;ZHOU Xinrong(Department of CCU,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院CCU,830054

出　　处：《心肺血管病杂志》2020年第12期1424-1428,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:分析冠心病患者经皮冠状动脉介入治疗(PCI)术后中性粒细胞外捕网(NETs)水平与支架内再狭窄的相关性。方法:将2017年1月至2018年12月,于我院行PCI治疗的222例患者纳入研究,术后对患者进行为期12个月的随访,根据患者是否出现支架内再狭窄将其分为再狭窄组及无再狭窄组,比较两组患者临床基线资料、手术相关因素及血液学指标等,采用多因素Logistic回归模型对影响支架内再狭窄的因素进行分析,并应用受试者工作曲线(ROC曲线)分析相关因素的预测价值。结果:再狭窄组患者合并糖尿病、吸烟的比例,术前狭窄程度,hs-CRP、NETs、血糖及TC水平明显高于无再狭窄组(均P<0.05),而两组患者的年龄、性别、病变部位等指标间无明显差异(均P>0.05);多因素Lo-gistic分析示高狭窄程度(OR=1.213,95%CI:1.016~1.448)、高hs-CRP水平(OR=1.352,95%CI:1.047~1.748)、高NETs水平(OR=109.032,95%CI:11.693~1016.661)、高TC水平(OR=3.635,95%CI:1.048~12.612)及高血糖水平(OR=1.607,95%CI:0.987~2.304)是PCI术后支架内再狭窄的危险因素,不吸烟(OR=0.146,95%CI:0.027~0.797)是PCI术后支架内再狭窄的保护因素;ROC曲线示NETs预测PCI术后支架内再狭窄的AUC为0.855,显著高于Hs-CRP、TC、吸烟、狭窄程度及血糖(Z=3.186,3.201,4.831,2.702,2.017;均P<0.05),其诊断的最佳截点为>1.38,此时其敏感性为90.3%,特异性为68.0%。结论:冠心病患者体内NETs水平能有效对患者PCI术后出现支架内再狭窄风险进行预测,具有较高的应用价值。Objective:To analyze the correlation between the levels of neutrophil extracellular traps(NETs)and intra-stent restenosis in patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods:A total of 222 patients who underwent PCI treatment in our hospital from January 2017 to December 2018 were included in the study.The patients were followed up for a period of 12 months after surgery.The stenosis group and non-restenosis group were compared with the clinical baseline data,surgical-related factors,and hematological indicators of the two groups of patients.Multivariate Logistic regression analysis was used to analyze the factors affecting restenosis in the stent.receiver operating characteristic curve(ROC curve)analyzes the predictive value of related factors.Results:The proportion of patients in the restenosis group with diabetes and smoking,preoperative stenosis,hs-CRP,NETs,blood sugar and TC levels were significantly higher than those in the non-restenosis group(all P<0.05),while the age of the two groups of patients There was no significant difference among indicators such as,gender,and lesion location(all P>0.05);multivariate Logistic analysis showed high degree of stenosis(OR=1.213,95%CI:1.016-1.448),high hs-CRP level(OR=1.352,95%CI:1.047-1.748),high NETs level(OR=109.032,95%CI:11.693-1016.661),high TC level(OR=3.635,95%CI:1.048-12.612)and high blood sugar level(OR=1.607,95%CI:0.987-2.304)is an independent risk factor for in-stent restenosis after PCI,non-smoking(OR=0.146,95%CI:0.027-0.797)is an independent protective factor for in-stent restenosis after PCI;ROC curve shows that the AUC of NETs predicting in-stent restenosis after PCI is 0.855,which is significantly higher than Hs-CRP,TC,smoking,degree of stenosis and blood glucose(Z=3.186,3.201,4.831,2.702,2.017;all P<0.05),The best cut-off point for diagnosis is>1.38.At this time,the sensitivity is 90.3%and the specificity is 68.0%.Conclusions:The level of NETs in patients with coronary heart disease can effectively predict the

关 键 词：经皮冠状动脉介入治疗 冠状动脉病变 支架内再狭窄 中性粒细胞外捕网 预测 

分 类 号：R54[医药卫生—心血管疾病]