血清CK、BGP、LTBP-2对冠状动脉支架植入术后再狭窄的预测价值  

The analysis of the value of serum CK,BGP,LTBP-2 in predicting restenosis after coronary stent implantatio

作　　者：王霏 常晓烨 张景鑫 WANG Fei;CHANG Xiaoye;ZHANG Jingxin(Coronary Heart Disease Intensive Care Unit,Zhangjiakou First Hospital,Zhangjiakou Hebei 075000,China)

机构地区：[1]张家口市第一医院冠心病重症监护科,河北张家口075000 [2]张家口市第一医院心内科,河北张家口075000

出　　处：《中国急救复苏与灾害医学杂志》2025年第3期290-294,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：河北省2023年度医学科学研究课题(20232064);张家口市重点研发计划项目(2221060D)。

摘　　要：目的评估血清肌酸激酶(CK)、骨钙素(BGP)、潜在转化生长因子结合蛋白2(LTBP-2)在预测患者冠状动脉支架植入后再狭窄中的应用价值。方法选取2020年1月—2023年1月在张家口市第一医院行冠状动脉支架植入术的113例患者为样本,收集所有患者的基本资料,并在术前行心脏超声和颈动脉超声检测,术后对患者进行为期1年的随访,根据随访结果将发生再狭窄的患者设为观察组,未发生再狭窄的患者为对照组。比较两组患者术前心功能指标以及血清中CK、BGP和LTBP-2水平。利用Logistic多因素分析评估患者术后再狭窄的风险因素,并利用ROC曲线评估中CK、BGP和LTBP-2水平对术后再狭窄的预测价值。结果113例患者中因治疗方案改变脱落7例,因病情变化脱落4例,因未完成随访脱落6例。最终有96例患者纳入统计分析,随访结果显示发生再狭窄的占比为40.62%(39/96)。观察组患者的植入支架数和支架直径高于对照组,且观察组患者术前的左心室舒张末内径(LVEDD)、颈动脉内膜中层厚度(CIMT)、CK和LTBP-2均比对照组增加,而左心室射血分数(LVEF)和BGP更低,差异有统计学意义(P<0.05)。Logistic分析显示患者术前心脏超声和颈动脉超声检测结果,以及血清指标水平均是影响其再狭窄的重要因素(P<0.05),ROC曲线显示CK、BGP和LTBP-2三者联合检测对术后再狭窄的预测准确度为0.958。结论术前检测血清中CK、BGP和LTBP-2水平对冠状动脉支架植入术后再狭窄的发生具有较好的预测价值。Objective To evaluate the application value of serum creatine kinase(CK),bone gla protein(BGP),and latent TGF-beta binding protein-2(LTBP-2)in predicting restenosis in patients after coronary stent implantation.Methods From January 2020 to January 2023,113 patients who underwent coronary stent implantation at Zhangjiakou First Hospital were selected as the sample.Basic patient data were collected,and all patients underwent preoperative cardiac and carotid ultrasound examinations.Patients were followed up for one year post-operatively.Based on the follow-up results,patients who experienced restenosis were categorized into the observation group,while those who did not were placed in the control group.Preoperative cardiac function indicators and serum levels of CK,BGP and LTBP-2 were compared between the two groups.Logistic multivariate analysis was used to assess risk factors for postoperative restenosis,and receiver operating characteristic(ROC)curves were utilized to evaluate the predictive value of CK,BGP,and LTBP-2 levels for postoperative restenosis.Results Out of the 113 patients,7 were excluded due to changes in treatment plans,4 were excluded due to changes in medical conditions,and 6 were excluded for not completing the follow-up.Ultimately,96 patients were included in the statistical analysis.Follow-up results showed that 40.62%(39/96)of the patients experienced restenosis.The number of stents implanted and stent diameter were higher in the observation group,and the preoperative LVEDD,CIMT,CK,and LTBP-2 levels were higher in the observation group than in the control group,while LVEF,BGP were lower,with significant statistical differences(P<0.05).Logistic analysis showed that preoperative echocardiography and carotid ultrasonography results,as well as serum indicator levels,were important factors affecting restenosis(P<0.05).The ROC curve showed that the combined detection of CK,BGP,and LTBP-2 had a predictive accuracy of 0.958 for postoperative restenosis.Conclusion Preoperative measurement of CK,BGP,and

关 键 词：血清肌酸激酶 骨钙素 潜在转化生长因子结合蛋白2 冠状动脉支架植入术 

分 类 号：R541.4[医药卫生—心血管疾病]