血清CysC、CT-1联合FFR值预测冠状动脉中度狭窄冠心病患者PCI术后主要心脏不良事件发生风险的临床研究  

Clinical Study on Serum CysC,CT-1 Combined with FFR Value in Predicting the Risk of Major Adverse Cardiac Events after PCI in Patients with Coronary Heart Disease with Moderate Coronary Artery Stenosis

作　　者：俞江 郑甲 陈建州 康丽娜 张荣林 YU Jiang;ZHENG Jia;CHEN Jian-zhou;KANG Li-na;ZHANG Rong-lin(Drum Tower Clinical College of Xuzhou Medical University,Nanjing,Jiangsu,210008,China;Department of Cardiovascular Medicine,Nanjing Drum Tower Hospital,Nanjing,Jiangsu,210008,China)

机构地区：[1]徐州医科大学鼓楼临床学院,江苏南京210008 [2]南京鼓楼医院心血管内科,江苏南京210008

出　　处：《现代生物医学进展》2024年第7期1306-1311,共6页Progress in Modern Biomedicine

基　　金：江苏省第五期"333工程"培养资金资助项目(BRA2017268)。

摘　　要：目的:探讨血清胱抑素C(Cys C)、心肌营养素-1(CT-1)联合冠状动脉血流储备分数(FFR)值预测冠状动脉中度狭窄冠心病患者经皮冠状动脉介入治疗(PCI)术后主要心脏不良事件(MACE)发生风险的预测价值。方法:选取2020年1月~2022年3月南京鼓楼医院收治的冠状动脉中度狭窄冠心病患者260例,根据PCI术后1年是否发生MACE分为MACE组36例和非MACE组224例。检测血清Cys C、CT-1水平和计算FFR值。构建多因素Logistic回归模型分析影响冠状动脉中度狭窄冠心病患者PCI术后MACE发生的风险因素,绘制受试者工作特征(ROC)曲线分析血清Cys C、CT-1联合FFR值对冠状动脉中度狭窄冠心病患者PCI术后MACE发生风险的预测价值。结果:随访1年,无失访病例,260例冠状动脉中度狭窄冠心病患者PCI术后MACE发生率为13.85%(36/260)。与非MACE组比较,MACE组血清Cys C、CT-1水平升高,FFR值降低(P<0.05)。多因素Logistic回归分析显示,KILLIP分级≥Ⅲ级、Cys C升高、CT-1升高为影响冠状动脉中度狭窄冠心病患者PCI术后MACE发生的独立危险因素,左室射血分数升高和FFR值升高为独立保护因素(P<0.05)。ROC曲线分析显示,血清Cys C、CT-1联合FFR值预测冠状动脉中度狭窄冠心病患者PCI术后MACE发生风险的曲线下面积为0.906,大于血清Cys C、CT-1、FFR值单独预测的0.771、0.775、0.797。结论:血清Cys C、CT-1水平升高和FFR值降低与冠状动脉中度狭窄冠心病患者PCI术后MACE发生密切相关,血清Cys C、CT-1联合FFR值预测冠状动脉中度狭窄冠心病患者PCI术后MACE发生风险的价值较高。Objective:To investigate the predictive value of serum cystatin C(CysC),cardiotrophin-1(CT-1)combined with coronary fractional flow reserve(FFR)in predicting the risk of major adverse cardiac events(MACE)after percutaneous coronary intervention(PCI)in patients with coronary heart disease with moderate coronary artery stenosis.Methods:260 patients with coronary heart disease with moderate coronary artery stenosis who were admitted to Nanjing Drum Tower Hospital from January 2020 to March 2022 were selected,patients were divided into MACE group(n=36)and non-MACE group(n=224)according to whether MACE occurred 1 year after PCI.Serum CysC and CT-1 levels were detected and FFR values were calculated.The risk factors affecting the occurrence of MACE after PCI in patients with coronary heart disease with moderate coronary artery stenosis were analyzed by constructed multivariate Logistic regression model,the predictive value of serum CysC,CT-1 combined with FFR value for the risk of MACE after PCI in patients with coronary heart disease with moderate coronary artery stenosis were analyzed by receiver operating characteristic(ROC)curve.Results:After 1 year of follow-up,there was no loss of follow-up,and the incidence of MACE after PCI in 260 patients with moderate coronary artery stenosis was 13.85%(36/260).Compared with non-MACE group,the levels of serum CysC and CT-1 in MACE group increased,and the FFR value decreased(P<0.05).Multivariate Logistic regression analysis showed that,KILLIP grade≥III,elevated CysC and elevated CT-1 were independent risk factors for MACE after PCI in patients with coronary heart disease with moderate coronary artery stenosis,and elevated left ventricular ejection fraction and elevated FFR were independent protective factors(P<0.05).ROC curve analysis showed that,the area under the curve of serum CysC,CT-1 combined with FFR in predicting the risk of MACE after PCI in patients with moderate coronary artery stenosis was 0.906,which was greater than 0.771,0.775 and 0.797 predicted by serum CysC

关 键 词：冠状动脉中度狭窄 经皮冠状动脉介入治疗 CysC CT-1 FFR 主要心脏不良事件 

分 类 号：R541.4[医药卫生—心血管疾病]