血清含凝血酶敏感素1型基序的解聚素样金属蛋白酶、组织金属蛋白酶抑制因子3水平与支架内再狭窄的关系  

Relationships of a disintegrin and metalloproteinase with thrombospondin motifs 1 in serum and tissue inhibitor of metalloproteinase 3 levels with in-stent restenosis

作　　者：杨婧[1] 郝明辉[1] 郭明[1] 郭金成[1] YANG Jing;HAO Minghui;GUO Ming;GUO Jincheng(Department of Cardiology,Beijing Luhe Hospital Affiliated to Capital Medical University,Beijing,101100)

机构地区：[1]首都医科大学附属北京潞河医院心内科,北京101100

出　　处：《实用临床医药杂志》2022年第24期97-101,共5页Journal of Clinical Medicine in Practice

基　　金：首都卫生科研发展专项项目(2018-2-7082)。

摘　　要：目的探讨血清含凝血酶敏感素1型基序的解聚素样金属蛋白酶(ADAMTS-1)、组织金属蛋白酶抑制因子3(TIMP3)水平与冠心病患者经皮冠状动脉介入治疗(PCI)后支架内再狭窄(ISR)的关系。方法选取455例行PCI的冠心病患者作为研究对象,根据随访1年后冠状动脉造影的影像学观察结果分为ISR组43例和非ISR组412例。采用Gensini评分及狭窄支数评价狭窄程度,采用酶联免疫吸附试验(ELISA)法检测ADAMTS-1、TIMP3水平。采用Spearman相关分析法分析ADAMTS-1、TIMP3水平与造影后Gensini评分的相关性;采用Pearson相关系数法分析ADAMTS-1与TIMP3的相关性;采用Logistic回归分析法分析ISR发生的影响因素;采用受试者工作特征(ROC)曲线评估ADAMTS-1、TIMP3对ISR发生的预测价值。结果与非ISR组相比,ISR组患者总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、ADAMTS-1水平升高,TIMP3水平降低,差异有统计学意义(P<0.05);ISR组血清ADAMTS-1水平与Gensini积分呈正相关(P<0.05),TIMP3水平与Gensini积分呈负相关(P<0.05);ISR组ADAMTS-1水平与TIMP3水平呈负相关(r=-0.616,P<0.001);多因素Logistic回归分析发现,ADAMTS-1高水平、TIMP3低水平均为ISR发生的独立危险因素(P<0.05);ROC曲线显示,ADAMTS-1与TIMP3联合预测ISR发生的曲线下面积显著大于两者单独预测(P<0.05)。结论ADAMTS-1和TIMP3水平与冠心病患者PCI后ISR的发生密切相关,两者是ISR发生的独立危险因素,对预测ISR发生具有重要价值。Objective To investigate relationships of the levels of a disintegrin and metalloproteinase with thrombospondin motifs 1(ADAMTS-1)and tissue inhibitor of metalloproteinase 3(TIMP3)in the serum with intrastent restenosis(ISR)in patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods A total of 455 patients with coronary heart disease who underwent PCI were selected as study objects,and were divided into ISR group(43 cases)and non-ISR group(412 cases)according to the imaging observation results of coronary angiography after one year of follow-up;Gensini score and the number of stenotic branches were used to evaluate the degree of stenosis;Enzyme-Linked Immunosorbent Assay(ELISA)method was used to detect the levels of ADAMTS-1 and TIMP3;Spearman’s method was used to analyze the correlations of ADAMTS-1 and TIMP3 levels with Gensini score after angiography;Pearson correlation coefficient method was used to analyze the correlation between ADAMTS-1 and TIMP3;Logistic regression was used to analyze the influencing factors of the occurrence of ISR;receiver operating characteristic(ROC)curve was used to evaluate the predictive value of ADAMTS-1 and TIMP3 for occurrence of ISR.Results Compared with the non-ISR group,the levels of total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C)and ADAMTS-1 levels in the ISR group were significantly increased,while the level of TIMP3 was significantly decreased(P<0.05);in the ISR group,the level of serum ADAMTS-1 was significantly positively correlated with Gensini score(P<0.05);the level of TIMP3 was significantly negatively correlated with Gensini score(P<0.05);the level of ADAMTS-1 was significantly negatively correlated with the level of TIMP3 in the ISR group(r=-0.616,P<0.001);multivariate Logistic regression analysis showed that high level of ADAMTS-1 and low level of TIMP3 were independent risk factors for ISR(P<0.05);compared with the single prediction of ADAMTS-1 or TIMP3,the area under the ROC curve of the combi

关 键 词：冠心病 经皮冠状动脉介入治疗 支架内再狭窄 组织金属蛋白酶抑制因子3 含凝血酶敏感素1型基序的解聚素样金属蛋白酶 

分 类 号：R654.2[医药卫生—外科学] R541.4[医药卫生—临床医学]