磷脂及鞘磷脂在冠状动脉支架内再狭窄中的研究  

Study on phospholipids and sphingomyelin in coronary artery stent restenosis

作　　者：苗旭光 崔松[1] 柳景华[1] 程姝娟[1] 赵东晖[1] 吴铮[1] 范谦[1] 王新[1] 李世英[1] 王韶屏[1] 郑泽[1] 王平[1] 李文铮[1] MIAO Xuguang;CUI Song;LIU Jinghua;CEHNG Shujuan;ZHAO Donghui;WU Zheng;FAN Qian;WANG Xin;LI Shiying;WANG Shaoping;ZHENG Ze;WANG Ping;LI Wenzheng(Department of Cardiology,Beijing Anzhen Hospital,Affiliated with Capital Medical University,Beijing,100029,China)

机构地区：[1]首都医科大学附属北京安贞医院心内科,北京100029

出　　处：《临床心血管病杂志》2023年第1期29-33,共5页Journal of Clinical Cardiology

摘　　要：目的:探究冠心病患者经皮冠状动脉介入治疗(PCI)后支架内再狭窄(ISR)的危险因素,以及磷脂和鞘磷脂代谢差异与ISR的关系。方法:纳入2017年1月—2020年12月在北京安贞医院进行首次PCI手术的冠心病患者共412例,根据PCI术后1年是否发生ISR分为ISR组(35例)和非ISR组(377例)。运用液相色谱串联质谱(LC-MS/MS)技术分析比对两组患者血液样本的代谢产物差异。采用多因素logistic回归分析筛选冠心病患者PCI后ISR的危险因素。结果:非ISR组与ISR组在高密度脂蛋白胆固醇(HDL-C)、血管病变数量、病变长度、支架内径、支架长度、后扩直径方面均差异有统计学意义(均P<0.05)。多因素logistic回归分析及代谢组学分析结果显示,非ISR组与ISR组患者血液代谢产物存在显著差异,主要为磷脂及鞘磷脂类代谢物的差异(均P<0.05)。结论:HDL-C、病变长度、支架内径及支架长度为冠心病患者PCI后ISR的影响因素,同时磷脂及鞘磷脂类代谢物在预测ISR的发生方面可能发挥着重要作用。Objective: To investigate the risk factors for in-stent restenosis(ISR) after percutaneous coronary intervention(PCI) in patients with coronary heart disease, and the relationship between differences in phospholipid and sphingolipid metabolism with ISR. Methods: A total of 412 patients with coronary heart disease who underwent their first PCI at Beijing Anzhen Hospital from January 2017 to December 2020 were included, and all patients were divided into the ISR group(n=35) and the non-ISR group(n=377) according to whether ISR occurred within 1 year after PCI. The differences in metabolites of patients’ blood samples between the two groups were analyzed using liquid chromatography tandem mass spectrometry(LC-MS/MS). Multi-factor logistic regression was used to analyze the risk factors for ISR after PCI in patients with coronary heart disease. Results: There were significant differences in high-density lipoprotein cholesterol(HDL-C), number of vascular lesions, lesion length, stent inner diameter, stent length, and post-dilation diameter between the ISR group and the non-ISR group(all P<0.05). Multi-factor logistic regression analysis and metabolomic analysis showed that there were significant differences in blood metabolites between the two groups, mainly the differences in phospholipids and sphingomyelin metabolites(all P<0.05). Conclusion: HDL-C, lesion length, stent inner diameter, and stent length are influencing factors of ISR after PCI in patients with coronary heart disease, and phospholipids and sphingolipid metabolites may play an important role in predicting the occurrence of ISR.

关 键 词：经皮冠状动脉介入 支架内再狭窄 代谢组学 磷脂 鞘磷脂 

分 类 号：R541.4[医药卫生—心血管疾病]