RBP4、ICAM-1与冠心病患者PCI术预后的相关性  

Correlation between RBP4,ICAM-1 and the prognosis of PCI in patients with coronary heart disease

作　　者：吴忠林 谢力民[2] WU Zhong-lin;XIE Li-min(Internal Medicine-Cardiovascular Department of Henan No.3 Provincial People's Hospital,Zhengzhou 450006,China)

机构地区：[1]河南省直第三人民医院心内科,河南郑州450006 [2]河南省胸科医院心内科,河南郑州450008

出　　处：《中国实验诊断学》2022年第9期1311-1315,共5页Chinese Journal of Laboratory Diagnosis

基　　金：四川省卫生健康委科研项目(18PJ060)。

摘　　要：目的探究血清视黄醇结合蛋白4(RBP4)、细胞间黏附分子(ICAM-1)与冠心病患者经皮冠状动脉介入术(PCI)预后的相关性。方法选取2017年11-12月500例行PCI术的冠心病患者,随访至2020年12月,根据预后情况分为不良组(n=72)、良好组(n=367)。比较两组术前血清RBP4、ICAM-1水平及其他可能影响因素;Logistic回归分析法分析PCI术预后不良的危险因素;绘制受试者工作曲线(ROC),评价血清RBP4、ICAM-1单独及联合预测冠心病PCI术预后不良的效能。结果平均随访时间(32.14±5.16)个月。61例患者失访,最终纳入的439例患者中72例发生主要心血管不良事件(MACE)(16.40%);与良好组比较,不良组糖尿病、冠脉病变支数≥3支构成比、血肌酐、血清RBP4、血清ICAM-1均高于良好组,HDL-C低于良好组(P<0.05);Logistic回归分析显示,HDL-C低、冠脉病变支数多及血肌酐、血清RBP4、血清ICAM-1高均是影响冠心病PCI术预后的危险因素(P<0.05);血清RBP4、ICAM-1预测冠心病PCI术后不良的最佳截断点分别为73.05mg/L、323.95ng/mL,两者单独及联合的AUC分别为0.755、0.624、0.835。结论冠心病患者PCI术预后不良患者血清RBP4、ICAM-1水平高,两者联合预测PCI术预后不良的效能较高。Objective To explore the correlation between serum retinol binding protein 4(RBP4),intercellular adhesion molecule-1(ICAM-1)and the prognosis of patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods 500 patients with coronary heart disease who underwent PCI from November to December2017 were selected and followed up to December 2020.According to the prognosis,they were divided into poor group(n=72)and good group(n=367).The preoperative serum RBP4,ICAM-1levels and other possible influencing factors between the two groups were compared.The risk factors for poor prognosis of PCI were analyzed by Logistic regression analysis.Draw receiver operating curve(ROC)to evaluate the efficacy of serum RBP4and ICAM-1alone and in combination in predicting poor prognosis of coronary heart disease PCI.Results The average follow-up time was(32.14±5.16)months.61 patients dropped out,and 72 of the 439 patients eventually enrolled had major cardiovascular adverse events(MACE)(16.40%).Compared with the good group,the diabetes and coronary artery diseased branches≥3 composition ratio,blood creatinine,serum RBP4,and serum ICAM-1 of the poor group were all higher,of which the HDL-C was lower(P<0.05).Logistic regression analysis showed that low HDL-C,high number of coronary artery lesions,high blood creatinine,serum RBP4,and serum ICAM-1were all risk factors affecting the prognosis of coronary heart disease PCI(P<0.05).The best cut-off points of serum RBP4 and ICAM-1 for predicting poor coronary heart disease after PCI are 73.05mg/L and 323.95ng/mL,and the AUC of the two alone and in combination are 0.755,0.624,0.835,respectively.Conclusion Patients with coronary heart disease with poor prognosis after PCI have high serum RBP4 and ICAM-1 levels,and the combination of the two has a higher efficacy in predicting poor prognosis of PCI.

关 键 词：冠心病 视黄醇结合蛋白4 细胞间黏附分子 经皮冠状动脉介入术 预后 

分 类 号：R541.4[医药卫生—心血管疾病]