甘油三酯-葡萄糖(TyG)指数与冠状动脉支架内再狭窄相关研究  

Correlation Research between Triglyceride Glucose(Tyg)Index and In-stent Restenosis of Coronary Arteries

作　　者：祖丽胡玛尔·艾萨 乔勇 鄢高亮 王栋 汤成春 Zulihummar Aisa;QIAO Yong;YAN Gaoliang;WANG Dong;TANG Chengchun(School of Medicine,Southeast University,Nanjing,Jiangsu 210009;Department of Cardiovascular Medicine,Southeast University Affiliated Zhongda Hospital,Nanjing,Jiangsu 210009)

机构地区：[1]东南大学医学院,江苏南京210009 [2]东南大学附属中大医院心血管内科,江苏南京210009

出　　处：《智慧健康》2024年第32期21-27,共7页Smart Healthcare

基　　金：国家自然科学基金资助项目《METTL3参与线粒体自噬促进低氧性肺动脉高压肺血管重塑的机制》(项目编号:82170433);南京市卫健委课题《绞股蓝总皂甙XLIX在糖尿病大鼠造影剂急性肾损伤作用机制研究》(项目编号:YKK22272)。

摘　　要：目的探讨甘油三酯-葡萄糖(TyG)指数与冠心病患者行经皮冠状动脉介入治疗(PCI)术后再狭窄风险的相关性研究。方法回顾性分析2021年10月—2022年12月在东南大学附属中大医院心血管内科接受PCI治疗后6—24个月复查冠状动脉造影的患者。根据TyG指数的最佳分界点值(8.47)将患者分为高TyG指数组(n=207)和低TyG指数组(n=207)。比较两组患者的基线特征、实验室检查、造影结果、出院带药等情况。同时根据造影后结果将患者分为再狭窄组(n=49)和非再狭窄组(n=363),通过单因素和多因素Logistic回归分析支架内再狭窄(ISR)的危险因素。结果本研究共纳入414例冠心病患者[(64.98±10.9)岁,68.1%为男性]。ISR发生率为11.8%(49例)。ISR组患者血肌酐、空腹甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、TyG指数、Gensini评分均高于非ISR(NISR)组患者(P<0.05)。受试者工作特征(ROC)曲线分析显示,TyG指数预测ISR发生的ROC曲线下面积为0.669(0.598~0.739,P<0.01),敏感度为95.9%,特异度为35.9%。而TyG指数联合Gensini评分预测再狭窄发生的ROC曲线下面积为0.743(0.677~0.808,P<0.01),敏感度66.7%,特异度71.5%。多因素Logistic回归分析结果显示,男性、体重指数(BMI)、白细胞计数、肌酐、TyG指数和Gensini评分均是冠心病PCI后ISR的独立危险因素。Spearman相关性分析显示,TyG指数与BMI、空腹血糖(FBG)、TG、总胆固醇(TC)、LDL-C、Gensini评分、ISR呈正相关。而TyG指数与性别、高密度脂蛋白胆固醇(HDL-C)呈负相关。结论本研究结果表明,TyG指数与冠心病PCI术后再狭窄之间存在明显的相关性。高TyG指数可能预示着较高的冠心病PCI后ISR风险。Objective To explore correlation between triglyceride glucose(TyG)index and restenosis risk after percutaneous coronary intervention of patients with coronary heart disease.Methods The paper reviewed and analyzed patients with PCI in Cardiology Department,Southeast University Affiliated Zhongda Hospital from October 2021 to December 2022,with coronary angiography reexamination after 6 to 24 months.According to the optimal cut-off point value of TyG index(8.47),patients were divided into high TyG index group(n=207)and low TyG index group(n=207).Baseline characteristics,laboratory examinations,angiographic results,and discharge medication were compared between two groups.At the same time,based on angiographic results,patients were divided into the ISR group(n=49)and non-ISR group(n=363),risk factors for ISR were analyzed with univariate and multivariate logistic regression.Results The paper included 414 patients with coronary heart disease(with age of 64.98±10.9,68.1%male)for st udy.Incidence of ISR was 11.8%(49 cases),and serum creatinine,TG,LDL-C,TyG index and GS scores of the ISR group were higher than non-ISR group(P<0.05).ROC curve analysis showed area under the ROC curve for predicting ISR incidence with TyG index was 0.669(0.598-0.739,P<0.01),with sensitivity of 95.9%and specificity of 35.9%.The area under the ROC curve for predicting restenosis with TyG index combined with Gensini scores was 0.743(0.677-0.808,P<0.01),with sensitivity of 66.7%and specificity of 71.5%.Multivariate logistic regression analysis showed,male,BMI,white blood cell count,creatinine,TyG index,and Gensini scores were independent risk factors for ISR of coronary heart disease after PCI.Spearman correlation analysis showed,TyG index was positively correlated with BMI,fasting blood glucose,TG,TC,LDL-C,Gensini scores and ISR.The TyG index was negatively correlated with gender and HDL-C.Conclusion The study results indicate,there is significant correlation between TyG index and restenosis of coronary heart disease after PCI.High TyG index

关 键 词：甘油三酯-葡萄糖指数 冠心病 支架内再狭窄 胰岛素抵抗 

分 类 号：R54[医药卫生—心血管疾病]