血清HbA1c、NT-proBNP、cTnI联合检测预测冠心病合并糖尿病PCI术后支架内再狭窄的价值  

The value of combined detection of serum HbA1c,NT-proBNP and cTnI in predicting instent restenosis after coronary heart disease complicated with diabetes mellitus after PCI

作　　者：杨青[1] 吕树志[1] 韦雪峰 YANG Qing;LV Shuzhi;WEI Xuefeng(Department of Cardiovascular Medicine,Nanyang Second People's Hospital,Nanyang,Henan,China,473000)

机构地区：[1]南阳市第二人民医院心血管内科,河南南阳473000

出　　处：《分子诊断与治疗杂志》2022年第11期1867-1870,1874,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河南省卫生厅重点项目(20200585X)。

摘　　要：目的 探讨糖化血红蛋白(HbA1c)、氨基末端脑钠肽前体(NT-proBNP)、心肌肌钙蛋白I(cTnI)联合检测对冠心病合并糖尿病经皮冠状动脉介入治疗(PCI)术后支架内再狭窄(ISR)的预测价值。方法 选取于2019年1月至2021年12月南阳市第二人民医院心内科确诊且行PCI术治疗的冠心病合并糖尿病患者256例,根据随访6个月是否发生ISR分为ISR组(n=45)和无ISR组(n=211)。检测血清HbA1c、NT-proBNP、cTnI水平,比较不同情况患者的血清HbA1c、NT-proBNP、c TnI水平。以血清HbA1c、NT-proBNP、cTnI水平作为自变量进行logistic回归分析,并采用受试者工作(ROC)曲线分析三者单独检测以及联合检测对PCI术后ISR的预测价值。结果 ISR组的血清HbA1c、NT-proBNP、cTnI水平高于无ISR组,差异具有统计学意义(t=6.678,3.220,5.268,P<0.05)。糖尿病病情程度轻度的血清HbA1c、NT-proBNP、cTnI水平低于重度,差异有统计学意义(t=8.852,2.900,4.508,P<0.05),冠脉病变严重程度的血清HbA1c、NT-proBNP、c TnI水平为:轻度<中度<重度,差异具有统计学意义(P<0.05)。Logistic回归分析显示,血清HbA1c、NT-proBNP、cTnI水平是PCI术后ISR的重要影响因素(P<0.05)。血清HbA1c、NT-proBNP、c TnI预测CPI术后ISR的AUC分别为0.814、0.851、0.863,三者联合检测预测CPI术后ISR的AUC为0.925,优于三者单独预测。结论 血清HbA1c、NT-proBNP、cTnI与冠心病合并糖尿病患者的病情具有一定的联系,三者联合检测具有较高的预测价值,能够在临床上推广使用。Objective To investigate the effect of combined detection of glycosylated hemoglobin(HbA1c),amino-terminal pro-brain natriuretic peptide(NT-proBNP)and cardiac troponin I(cTnI)on in-stent restenosis after percutaneous coronary intervention(PCI)for coronary heart disease complicated with diabetes mellitus(ISR)predictive value. Methods A total of 256 patients with coronary heart disease and diabetes who were diagnosed by the Department of Cardiology of Nanyang Second People’s Hospital and treated by PCI from January 2019 to December 2021 were selected and divided into the ISR group(n=45)and the non-ISR group(n=211). Serum HbA1c,NT-proBNP,and cTnI levels were detected,and serum HbA1c,NT-proBNP,and cTnI levels in patients with different conditions were compared. Logistic regression analysis was performed with serum HbA1c,NT-proBNP,and cTnI levels as independent variables,and receiver operating(ROC)curve was used to analyze the predictive value of the three alone and combined detection on ISR after PCI. Results The levels of serum Hb A1c,NT-pro BNP and c Tn I in the ISR group were higher than those in the non-ISR group,and the difference was statistically significant(t=6.678,3.220,5.268,P<0.05). The levels of serum Hb A1c,NT-pro BNP and c Tn I in the mild degree of diabetes were lower than those in the severe degree(t=8.852,2.900,4.508,P<0.05). Serum Hb A1c,NT-pro BNP,and c Tn I levels in the severity of coronary artery disease were:mild < moderate < severe,and the difference was statistically significant(t=22.501,8.875,30.881,P<0.05). Logistic regression analysis showed that serum Hb A1c,NT-pro BNP and c Tn I levels were important influencing factors of ISR after PCI(P<0.05). The AUCs of serum Hb A1c,NT-pro BNP,and c Tn I for predicting ISR after CPI were 0.814,0.851,and 0.863,respectively. The AUC of the three combined detection for predicting ISR after CPI was 0.925,which was better than the three alone. Conclusion Serum Hb A1c,NTpro BNP,and c Tn I have a certain relationship with the condition of patients with co

关 键 词：冠心病合并糖尿病 经皮冠状动脉介入治疗 糖化血红蛋白 氨基末端脑钠肽前体 心肌肌钙蛋白I 

分 类 号：R541.4[医药卫生—心血管疾病] R587.1[医药卫生—内科学]