血清dp-ucMGP、OSMR、CTRP15与急性冠脉综合征患者冠状动脉病变程度及PCI术后支架内再狭窄的关系  

Relationship between serum dp-ucMGP,OSMR,CTRP15 and the degree of coronary artery disease and in-stent restenosis after PCI in patients with acute coronary syndrome

作　　者：段文娟 任保军[2] DUAN Wenjuan;REN Baojun(Inner Mongolia Medical University Xinhua Campus Medical Center,Hohhot,Inner Mongolia 010030,China;Medical Management Center,Affiliated Hospital of Inner Mongolia Medical University,Hohhot,Inner Mongolia 010050,China)

机构地区：[1]内蒙古医科大学新华校区医务所,内蒙古呼和浩特010030 [2]内蒙古医科大学附属医院医务部,内蒙古呼和浩特010050

出　　处：《国际检验医学杂志》2025年第6期742-747,共6页International Journal of Laboratory Medicine

摘　　要：目的探讨血清去磷酸化未羧化基质Gla蛋白(dp-ucMGP)、制瘤素受体(OSMR)、C1q肿瘤坏死因子相关蛋白15(CTRP15)与急性冠脉综合征(ACS)患者冠状动脉病变程度及经皮冠状动脉介入治疗(PCI)术后支架内再狭窄的关系。方法选取2021年1月至2023年1月在该院行PCI治疗的162例ACS患者为研究对象,根据冠状动脉病变程度分为低病变组(n=48)、中病变组(n=80)和高病变组(n=34),根据随访记录将患者分为狭窄组(n=40)和非狭窄组(n=122)。检测ACS患者血清dp-ucMGP、OSMR、CTRP15水平,收集分析一般临床资料,采用多因素Logistic回归分析患者PCI术后支架内再狭窄的影响因素,绘制受试者工作特征(ROC)曲线分析dp-ucMGP、OSMR、CTRP15对患者PCI术后支架内再狭窄的预测价值。结果与低病变组比较,中病变组、高病变组血清dp-ucMGP水平升高(P<0.05),OSMR、CTRP15水平降低(P<0.05);与中病变组比较,高病变组血清dp-ucMGP水平升高(P<0.05),OSMR、CTRP15水平降低(P<0.05)。狭窄组病变长度、术前狭窄程度、支架长度及血清肌钙蛋白I(cTnI)、N末端B型脑钠肽前体(NT-proBNP)、C反应蛋白(CRP)、dp-ucMGP水平高于非狭窄组(P<0.05),OSMR、CTRP15水平低于非狭窄组(P<0.05)。dp-ucMGP、OSMR、CTRP15单独及联合预测患者PCI术后发生支架内再狭窄的曲线下面积(AUC)分别为0.839、0.849、0.838、0.922,联合预测的AUC大于dp-ucMGP(Z=2.304,P=0.021)、OSMR(Z=2.073,P=0.038)、CTRP15(Z=2.414,P=0.016)单独预测。支架长度及血清CRP、dp-ucMGP水平为患者PCI术后支架内再狭窄的危险因素,CTRP15、OSMR水平为保护因素(P<0.05)。结论PCI术后支架内再狭窄ACS患者血清dp-ucMGP水平升高,OSMR、CTRP15水平降低,与患者冠状动脉病变程度及PCI术后支架内再狭窄有关,对患者术后支架内再狭窄具有一定辅助预测价值。Objective To investigate the relationship between serum dephosphorylated uncarboxylated matrix Gla protein(dp-ucMGP),oncostatin receptor(OSMR),C1q tumor necrosis factor-related protein 15(CTRP15)and the degree of coronary artery disease and in-stent restenosis after percutaneous coronary intervention(PCI)in patients with acute coronary syndrome(ACS).Methods A total of 162 ACS patients who underwent PCI in this hospital from January 2021 to January 2023 were selected as the research objects.According to the degree of coronary artery disease,the patients were divided into low lesion group(n=48),medium lesion group(n=80)and high lesion group(n=34).According to follow-up records,the patients were divided into stenosis group(n=40)and non-stenosis group(n=122).Serum dp-ucMGP,OSMR and CTRP15 levels were detected,and general clinical data were collected and analyzed in ACS patients.Multivariate Logistic regression was used to analyze the influencing factors of in-stent restenosis after PCI.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of dp-ucMGP,OSMR and CTRP15 for in-stent restenosis after PCI.Results Compared with the low lesion group,the serum levels of dp-ucMGP in the medium lesion group and the high lesion group were increased(P<0.05),while the levels of OSMR and CTRP15 were decreased(P<0.05).Compared with the medium lesion group,the serum level of dp-ucMGP in the high lesion group was increased(P<0.05),while the levels of OSMR and CTRP15 were decreased(P<0.05).The lesion length,preoperative stenosis degree,stent length and serum troponin I,N-terminal pro-B-type natriuretic peptide,C-reactive protein(CRP),dp-ucMGP levels in stenosis group were higher than those in non-stenosis group(P<0.05),while OSMR and CTRP15 levels were lower than those in non-stenosis group(P<0.05).The area under the curve(AUC)of dp-ucMGP,OSMR and CTRP15 alone and in combination for predicting in-stent restenosis after PCI was 0.839,0.849,0.838 and 0.922,respectively.The AUC of combined prediction wa

关 键 词：去磷酸化未羧化基质Gla蛋白 制瘤素受体 C1q肿瘤坏死因子相关蛋白15 急性冠脉综合征 经皮冠状动脉介入治疗 支架内再狭窄 

分 类 号：R543.3[医药卫生—心血管疾病]