血管生成素样蛋白2与血管生成素样蛋白1比值与急性心肌梗死介入术后支架内再狭窄的关系  

Relationship between the ratio of Angptl2/Angptl1 and in-stent restenosis after PCI in patients with acute myocardial infarction

作　　者：杨宁[1] 司定然[1] 梁彦丽 王金鹏 李芹[1] YANG Ning;SI Dingran;LIANG Yanli;WANG Jinpeng;LI Qin(Department of Cardiovascular Medicine,Puyang Oilfield General Hospital,Puyang,Henan 457001,China)

机构地区：[1]濮阳市油田总医院心血管内科,河南濮阳457001

出　　处：《安徽医药》2023年第7期1433-1437,共5页Anhui Medical and Pharmaceutical Journal

基　　金：河南省医学科技攻关联合共建项目(LHGJ20221016)。

摘　　要：目的探讨血管生成素样蛋白2与血管生成素样蛋白1比值(Angptl2/Angptl1)与急性ST段抬高型心肌梗死(STEMI)病人经皮冠状动脉介入(PCI)术后支架内再狭窄(ISR)的关系。方法选取2017年1月至2020年9月在濮阳市油田总医院行急诊PCI的STEMI病人221例为研究对象,均术后随访12个月,按冠状动脉造影检查的结果将其分为狭窄组(发生ISR的35例)和未狭窄组(未发生ISR的186例)。比较两组一般资料;血清Angptl1、Angptl2水平,计算Angptl2/Angptl1;logistic回归分析STEMI病人PCI术后ISR的影响因素;受试者操作特征(ROC)曲线评价Angptl2/Angptl1诊断STEMI病人PCI术后ISR的价值。结果狭窄组STEMI病人支架直径、血清Angptl1水平低于未狭窄组[(2.92±0.47)mm比(3.39±0.51)mm,(1.45±0.48)mg/L比(2.01±0.67)mg/L,t=5.06、4.72,P<0.05],血清Angptl2水平及Angptl2/Angptl1高于未狭窄组[(2.54±0.85)mg/L比(1.78±0.60)mg/L,1.75±0.59比0.89±0.30,t=6.39、12.94,P<0.05];Angptl2/Angptl1[OR 95%CI:2.95(1.76,4.93),P<0.05]是STEMI病人PCI术后发生ISR的危险因素,支架直径[OR 95%CI:0.58(0.48,0.72),P<0.05]是STEMI病人PCI术后发生ISR的保护因素;Angptl2/Angptl1诊断STEMI病人PCI术后发生ISR的曲线下面积(AUC)为0.90,截断值为1.31,其灵敏度为82.9%,特异度为87.1%。结论PCI术后ISR的STEMI病人Angptl2/Angptl1较高,Angptl2/Angptl1有望作为诊断STEMI病人行PCI术后ISR的潜在指标。Objective To investigate the relationship between angiopoietin like protein 2/angiopoietin like protein 1(Angptl2/Angptl1)ratio and in stent restenosis(ISR)after percutaneous coronary intervention(PCI)in patients with ST-segment elevation myocardial infarction(STEMI).Methods A total of 221 STEMI patients who underwent emergency PCI in Puyang Oilfield General Hospital from January 2017 to September 2020 were selected as the research objects.All STEMI patients were followed up for 12 months after surgery.According to the results of coronary angiography,they were assigned into stenosis groups(occurring 35 STEMI patients with ISR)and the non-stenosis group(186 STEMI patients without ISR).The general data,serum Angptl1 and Angptl2 level were compared between the stenosis group and the non-stenosis group,and the ratio of Angptl2/Angptl1 was calculated;Logistic regression was used to analyze the influencing factors of restenosis in STEMI patients after PCI;the receiver operating characteristic(ROC)curve evaluated the value of Angptl2/Angptl1 ratio in the diagnosis of ISR after PCI in patients with STEMI.Results The stent diameter and serum Angptl1 level of STEMI patients in the stenosis group were lower than those in the non-stenosis group[(2.92±0.47)mm vs.(3.39±0.51)mm,(1.45±0.48)mg/L vs.(2.01±0.67)mg/L,t=5.06,4.72,P<0.05],and the serum Angptl2 level and Angptl2/Angptl1 ratio were higher than those of the non-stenosis group[(2.54±0.85)mg/L vs.(1.78±0.60)mg/L,1.75±0.59 vs.0.89±0.30,t=6.39,12.94,P<0.05];Angptl2/Angptl1 ratio[OR 95%CI:2.95(1.76,4.93),P<0.05]was a risk factor of ISR in STEMI patients after PCI,stent diameter[OR 95%CI:0.58(0.48,0.72),P<0.05]was a protective factor of ISR in STEMI patients after PCI;the area under the curve(AUC)of the Angptl2/Angptl1 ratio in the diagnosis of ISR after PCI in STEMI patients was 0.90,the cutoff value was 1.31,the sensitivity was 82.9%,and the specificity was 87.1%.Conclusion The Angptl2/Angptl1 ratio of STEMI patients with ISR after PCI is high.The Angptl2/Angptl1 rat

关 键 词：ST段抬高型心肌梗死 冠状动脉再狭窄 血管生成素样蛋白1 经皮冠状动脉介入术 诊断价值 

分 类 号：R542.22[医药卫生—心血管疾病]