细胞周期蛋白D2水平与急性心肌梗死患者PCI术后冠状动脉无复流的相关性分析  

Correlation between Cyclin D2 Level and Coronary Non-ref low After PCI for Patients with Acute Myocardial Infarction

作　　者：冯云霞 张虹 李冬梅[1] 苏维芳[1] 马建琴[1] FENG Yunxia;ZHANG Hong;LI Dongmei;SU Weifang;MA Jianqin(Emergency Department of the Second Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China;Operating Room,Hebei Huaao Hospital,Zhangjiakou 075000,Hebei,China)

机构地区：[1]河北北方学院附属第二医院急诊科,075000 [2]河北华奥医院手术室,075000

出　　处：《中国分子心脏病学杂志》2023年第6期5729-5735,共7页Molecular Cardiology of China

基　　金：2023年度河北省医学科学研究课题计划(20231467)。

摘　　要：目的 探讨细胞周期蛋白D2(CCND2)水平与急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术后冠状动脉无复流(NR)的相关性。方法 选取2020年1月至2022年1月收治的因患AMI而进行PCI术的患者180例为AMI组,同时选取同期健康体检者150例为对照组。采用荧光定量PCR检测血清CCND2表达水平;采用logistic多因素回归分析AMI患者PCI术后发生冠状动脉NR的影响因素;采用受试者操作特征(ROC)曲线来评价血清CCND2对AMI患者PCI术后发生冠状动脉NR的预测价值。结果 相较于对照组,AMI组血清CCND2水平显著降低(P <0.05)。与非NR组相比,NR组的CCND2水平显著降低,Gensini评分、就诊到导管室时间、开通冠状动脉时间、C反应蛋白(CRP)、中性粒细胞与淋巴细胞比值(NLR)、纤维蛋白原与白蛋白比值(FAR)显著上升(P <0.05)。CCND2与就诊到导管室时间、开通冠状动脉时间、CRP、NLR、FAR呈负相关(P <0.05);控制年龄、Gensini评分因素后进行偏相关分析,CCND2与就诊到导管室时间、开通冠状动脉时间、CRP、NLR、FAR呈负相关(P <0.05)。多因素logistic回归分析发现,高水平Gensini评分、CRP、NLR、FAR均是AMI患者PCI术后发生冠状动脉NR的独立危险因素,CCND2是AMI患者PCI术后发生冠状动脉NR的独立保护因素(P <0.05)。ROC曲线结果显示,血清CCND2水平的曲线下面积(AUC)为0.843(Z=10.504,P <0.05)。结论 AMI患者血清CCND2水平降低,且PCI术后NR患者的CCND2水平低于非NR患者。高水平CCND2是AMI患者PCI术后发生冠状动脉NR的保护因素,CCND2水平对AMI患者PCI术后发生冠状动脉NR具有较高的预测价值。Objective To investigate the correlation between cyclin D2(CCND2) level and coronary no reflow(NR) after percutaneous coronary intervention(PCI) for patients with acute myocardial infarction(AMI).Methods From January 2020 to January 2022,180 patients with AMI who underwent PCI in our hospital were selected as AMI group,at the same time,150 healthy people in the same period were selected as the control group.The expression of CCND2 in serum was detected by fluorescence quantitative PCR;Logistic regression was used to analyze the influencing factors of coronary NR in AMI patients after PCI;the predictive value of serum CCND2 for coronary NR in AMI patients after PCI was evaluated by receiver operating characteristic(ROC) curve.Results Compared with the control group,the serum CCND2 level in AMI group decreased obviously(P <0.05).Compared with the non NR group,the CCND2 in the NR group decreased obviously,and Gensini score,time from visit to catheter room,time to open coronary artery,CRP,NLR,FAR increased obviously(P <0.05).CCND2 was negatively correlated with the time to visit the catheter room,the time to open coronary artery,CRP,NLR and FAR(P<0.05);After controlling the age and Gensini score,the partial correlation analysis showed that CCND2 was negatively correlated with the time to visit the catheter room,the time to open coronary artery,CRP,NLR and FAR(P<0.05).Logistic regression analysis showed that high levels of Gensini score,CRP,NLR and FAR were independent risk factors for coronary NR in AMI patients after PCI,and CCND2 was independent protective factor for coronary NR in AMI patients after PCI(P <0.05).ROC curve showed that AUC of serum CCND2 level was 0.843(Z=10.504,P<0.05).Conclusion The level of serum CCND2 in AMI patients is decreased,and the level of CCND2 in NR patients after PCI is lower than that in non NR patients.High level of CCND2 is a protective factor for coronary NR in AMI patients after PCI,and has high predictive value for coronary NR in AMI patients after PCI.

关 键 词：急性心肌梗死 细胞周期蛋白D2 经皮冠状动脉介入术 预测价值 

分 类 号：R542.22[医药卫生—心血管疾病]