血清DKK1、DKK3水平对冠心病经皮冠状动脉介入治疗术后支架内再狭窄的预测价值  

Predictive value of serum DKK1 and DKK3 levels for in-stent restenosis after percutaneous coronary intervention in coronary heart disease

作　　者：王成红 单兴华 WANG Cheng-hong;SHAN Xing-hua(Department of Cardiovascular Medicine,The First Affiliated Hospital of the Naval Military Medical University,Shanghai 200433,China)

机构地区：[1]海军军医大学第一附属医院心血管内科,上海200433

出　　处：《临床和实验医学杂志》2025年第6期580-584,共5页Journal of Clinical and Experimental Medicine

基　　金：上海市卫生健康委员会科研课题支持项目(编号:202040038)。

摘　　要：目的探讨血清Dickkopf相关蛋白(DKK)1、DKK3水平对冠心病经皮冠状动脉介入(PCI)治疗术后支架内再狭窄的预测价值。方法前瞻性选取2022年3月至2024年2月入海军军医大学第一附属医院行PCI术后的冠心病患者203例作为研究对象,设为冠心病组;另选取同期收治的非心血管疾病的住院患者95例为对照组。比较两组患者血清DKK1、DKK3水平。经6个月的随访,根据患者PCI术后是否发生支架内再狭窄,将其分为再狭窄组(n=52)和非再狭窄组(n=151)。采用单因素和多因素Logistic回归分析对冠心病行PCI术后发生支架内再狭窄的影响因素进行分析;采用受试者操作特征(ROC)曲线分析DKK1、DKK3水平对PCI术后再狭窄的预测效能。结果冠心病组患者血清中DKK1和DKK3水平分别为(15.27±4.93)、(75.32±10.93)ng/mL,均明显高于对照组[(6.69±2.16)、(40.51±9.27)ng/mL],差异均有统计学意义(P<0.05)。再狭窄组的吸烟及糖尿病人数占比、总胆红素(TBil)、糖化血红蛋白(GHb)、DKK1和DKK3水平分别为51.92%、36.54%、(22.75±5.73)μmol/L、(7.03±1.15)%、(18.15±5.72)ng/mL、(87.63±11.84)ng/mL,均明显高于非再狭窄组[31.79%、20.53%、(11.36±3.91)μmol/L、(6.32±1.01)%、(13.94±3.87)ng/mL、(60.43±9.18)ng/mL],差异均有统计学意义(P<0.05)。多因素Logistic回归模型结果显示,TBil、GHb、DKK1和DKK3均是PCI术后再狭窄的危险因素(P<0.05)。ROC曲线分析结果显示,血清DKK1、DKK3和DKK1+DKK3的曲线下面积(AUC)为0.829(95%CI:0.768~0.892)、0.898(95%CI:0.851~0.945)、0.938(95%CI:0.904~0.973),敏感度分别为84.31%、75.58%和90.21%,特异度分别为86.27%、70.59%和72.55%,DKK1+DKK3联合检测冠心病患者PCI术后发生支架内再狭窄的AUC值和敏感度均明显高于DKK1、DKK3单独检测(P<0.05)。结论PCI术后支架内再狭窄患者血清DKK1、DKK3水平均明显高于非再狭窄患者,血清DKK1、DKK3水平对冠心病患者PCI术后发生支架内再狭窄具有一定的�Objective To investigate the predictive value of serum Dickkopf-recated protein(DKK)1 and DKK3 levels for in-stent restenosis after percutaneous coronary intervention(PCI).Methods A total of 203 patients with coronary heart disease admitted to The First Affiliated Hospital of the Naval Military Medical University after PCI from March 2022 to February 2024 were prospectively selected as the study objects,as the coronary heart disease group,and 95 hospitalized patients with non-cardiovascular disease during the same period were selected as the control group.The serum levels of DKK1 and DKK3 were compared between the two groups.After 6-12 months of follow-up,patients were divided into the restenosis group(n=52)and the non restenosis group(n=151)based on whether they experienced in stent restenosis after PCI.The influencing factors of in-stent restenosis after PCI in coronary heart disease were analyzed by univariate and multivariate Logistic regression analysis.The predictive efficacy of DKK1 and DKK3 levels for restenosis after PCI was analyzed using the receiver operating characteristic(ROC)curve.Results The serum levels of DKK1 and DKK3 in coronary heart disease group were(15.27±4.93)and(75.32±10.93)ng/mL,respectively,which were significantly higher than those in the control group[(6.69±2.16)and(40.51±9.27)ng/mL],the differences were statistically significant(P<0.05).The proportion of smoking and diabetes,total bilirubin(TBil),glycosylated hemoglobin(GHb),DKK1 and DKK3 levels in the restenosis group were 51.92%,36.54%,(22.75±5.73)μmol/L,(7.03±1.15)%,(18.15±5.72)ng/mL,(87.63±11.84)ng/mL,respectively.They were significantly higher than those in the non-restenosis group[31.79%,20.53%,(11.36±3.91)μmol/L,(6.32±1.01)%,(13.94±3.87)ng/mL,(60.43±9.18)ng/mL],the differences were statistically significant(P<0.05).The multivariate Logistic regression model results showed that TBil,GHb,DKK1,and DKK3 were independent risk factors for in-stent restenosis after coronary heart disease PCI(P<0.05).The ROC curve analy

关 键 词：冠心病 冠状动脉再狭窄 经皮冠状动脉介入 Dickkopf相关蛋白1 Dickkopf相关蛋白3 预测价值 

分 类 号：R541.4[医药卫生—心血管疾病]