冠心病患者血清bFGF、sTLT-1水平与支架置入术后再狭窄的关系  

Correlation of serum bFGF and sTLT-1 levels with in-stent restenosis afteRstent implantation in patients with coronary heart disease

作　　者：吴瑕[1] 丁静[1] WU Xia;DING Jing(Department of Cardiothoracic Surgery,Mianyang Central Hospital,Sichuan,Mianyang 621000,China)

机构地区：[1]四川省绵阳市中心医院心胸外科,621000

出　　处：《河北医药》2024年第11期1622-1626,共5页Hebei Medical Journal

基　　金：四川省卫生健康委员会科研课题(普及应用项目)(编号:19PJ011)。

摘　　要：目的探讨冠心病患者血清碱性成纤维细胞生长因子(bFGF)、可溶性髓样细胞触发受体样转录因子1(sTLT-1)水平与支架置入术后支架内再狭窄(ISR)的关系。方法收集2020年1月至2022年3月收治的冠心病行支架置入术患者450例。根据术后1年复查是否发生ISR分为ISR组(41例)、非ISR组(409例)。比较ISR组与非ISR组一般资料、实验室相关指标、血清bFGF、sTLT-1水平;Pearson法分析冠心病支架置入术后ISR患者血清bFGF、sTLT-1水平的相关性;Logistic回归分析冠心病患者支架置入术后发生ISR的影响因素;ROC曲线分析血清bFGF、sTLT-1水平诊断冠心病患者支架置入术后发生ISR的临床价值。结果ISR组狭窄程度、植入支架数量、术前Gensini评分、血清sTLT-1、CRP水平显著高于非ISR组,支架直径、血清bFGF、CysC水平显著低于非ISR组(P<0.05);Ⅲ级组血清bFGF水平显著高于Ⅳ级组(P<0.05),Ⅲ级组血清sTLT-1水平显著低于Ⅳ级组(P<0.05);冠心病支架置入术后发生ISR的患者血清bFGF与sTLT-1水平呈负相关(R=-0.648,P<0.001);sTLT-1、CRP是冠心病患者支架置入术后发生ISR的危险因素,bFGF、CysC是保护因素(P<0.05);血清bFGF、sTLT-1两者联合诊断冠心病患者支架置入术后发生ISR的AUC为0.901,优于各自单独诊断(Z二者联合-bFGF=3.086、Z二者联合-sTLT-1=2.754,P=0.002、P=0.030),联合诊断的敏感度为89.80%,特异性为76.12%。结论冠心病支架置入术后发生ISR的患者血清bFGF水平下调,sTLT-1水平上调,二者均是ISR的影响因素,且联合诊断冠心病患者支架置入术后ISR的发生具有较高效能。Objective To investigate the correlation of serum levels of basic fibroblast growth factoR(bFGF)and soluble triggering receptoRexpressed on myeloid cells 1(sTLT-1)in patients with coronary heart disease with in-stent restenosis(ISR)afteRstent implantation.Methods From January 2020 to March 2022,450 patients with coronary heart disease who underwent stent implantation in ouRhospital were enrolled.They were divided into ISRgroup(41 cases)and non-ISRgroup(409 cases)based on the occurrence of ISRafteR1-yeaRfollow-up.The general information,laboratory indicators,and serum bFGF and sTLT-1 levels were compared between the two groups.Pearson correlation was applied to analyze the correlation of serum bFGF and sTLT-1 levels with ISRin patients with coronary heart disease afteRstent implantation.Logistic regression was applied to analyze the influencing factors of ISRin patients with coronary heart disease afteRstent implantation.The receiveRoperating characteristic(ROC)curves were plotted to analyze the clinical value of serum bFGF and sTLT-1 levels in diagnosing ISRafteRstent implantation in patients with coronary heart disease.Results The degree of stenosis,numbeRof implanted stents,preoperative Gensini score,and serum sTLT-1 and C-reactive protein(CRP)levels in the ISRgroup were significantly higheRin ISRgroup than those of the non-ISRgroup,while the stent diameter,and serum bFGF and cystatin C(cysC)levels were significantly loweR(P<0.05).Serum bFGF levels in gradeⅢpatients were significantly higheRthan those with gradeⅣ(P<0.05),and serum sTLT-1 levels in gradeⅢpatients were significantly loweR(P<0.05).There was a negative correlation between serum bFGF and sTLT-1 levels in patients with ISRafteRstent implantation foRcoronary heart disease(R=-0.648,P<0.001).STLT-1 and CRP were risk factors foRISRin patients with coronary heart disease afteRstent implantation,while bFGF and CysC were protective factors(P<0.05).The area undeRthe curve(AUC)of a combination measurement of serum bFGF and sTLT-1 levels in the diagnosis

关 键 词：冠心病 碱性成纤维细胞生长因子 可溶性髓样细胞触发受体样转录因子1 支架置入 支架内再狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]