血清HbA1c、Sema7A联合预测冠心病PCI术后支架内再狭窄的价值  

Value of Serum HbA1c and Sema7A in Predicting In-stent Restenosis in Coronary Heart Patients After PCI

作　　者：邢春杰 郭青榜 XING Chunjie;GUO Qingbang(Department of Cardiovascular Medicine,Nanyang Central Hospital,Nanyang 473000,China;Special Need Department of Cardiovascular Medicine,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院心血管内科,河南南阳473000 [2]南阳市中心医院心血管内科特需病区,河南南阳473000

出　　处：《河南医学研究》2025年第8期1449-1454,共6页Henan Medical Research

摘　　要：目的 探讨信号蛋白7A(Sema7A)、糖化血红蛋白(HbA1c)联合预测冠心病经皮冠状动脉介入治疗(PCI)术后支架内再狭窄(ISR)的价值。方法 选取2020年1月至2023年4月南阳市中心医院收治的240例冠心病患者作为研究组,按照2∶1匹配原则选取同期120例健康体检者作为对照组,根据PCI术后1 a内ISR发生情况将冠心病患者分为ISR组和非ISR组。比较研究组(入院时)和对照组(体检当天)HbA1c、Sema7A水平,比较研究组PCI术前不同冠脉狭窄程度患者入院时HbA1c、Sema7A水平,并比较ISR组和非ISR组入院时一般资料、HbA1c、Sema7A水平;采用Spearman法分析HbA1c、Sema7A水平与冠脉狭窄程度的相关性,采用logistic回归分析发生ISR的影响因素,采用受试者工作特征(ROC)曲线分析预测价值。结果 入院时研究组患者的HbA1c、Sema7A水平高于对照组,差异有统计学意义(P<0.05);入院时重度患者的HbA1c、Sema7A水平高于中度、轻度患者,中度患者的HbA1c、Sema7A水平高于轻度患者,差异有统计学意义(P<0.05);经Spearman法分析结果显示,冠心病患者入院时HbA1c、Sema7A水平与冠脉狭窄程度呈正相关(r=0.512、0.468,P<0.05);ISR组患者的糖尿病占比、高血压占比、冠脉狭窄程度、支架数目≥2枚占比、主支架直径<3.5 mm占比、主支架长度≥30 mm占比、入院时HbA1c、Sema7A水平高于非ISR组,差异有统计学意义(P<0.05);入院时HbA1c、Sema7A水平均为患者PCI术后发生ISR的影响因素(P<0.05);ROC分析结果显示,入院时HbA1c、Sema7A单独、联合预测PCI术后发生ISR的曲线下面积(AUC)为0.771、0.762、0.922,二者联合AUC最高。结论 HbA1c、Sema7A在冠心病患者中高表达,与PCI术后ISR、术前冠脉狭窄程度有关,HbA1c、Sema7A可用于辅助评估PCI术后ISR,为临床预后评估提供参考指标。Objective To investigate the value of semaphorin 7A(Sema7A)and hemoglobin A1c(HbA1c)in predicting in-stent restenosis(ISR)after percutaneous coronary intervention(PCI).Methods A total of 240 patients with coronary heart disease admitted to Nanyang Central Hospital from January 2020 to April 2023 were selected as the study group,and 120 healthy subjects in the same period were selected as the control group according to the 2∶1 matching principle.The patients with coronary heart disease were divided into ISR group and non-ISR group according to the occurrence of ISR within one year after PCI.The levels of HbA1c and Sema7A in the study group(at admission)and the control group(on the day of physical examination)were compared,the levels of HbA1c and Sema7A in the study group at admission of patients with different degrees of coronary artery stenosis before PCI were compared,and the general information,HbA1c and Sema7A levels at admission between the ISR group and the non-ISR group were compared.Spearman method was used to analyze the correlation between HbA1c and Sema7A levels and the degree of coronary artery stenosis,logistic regression was used to analyze the influencing factors of ISR,and receiver operating characteristic(ROC)curve was used to analyze the predictive value.Results The levels of HbA1c and Sema7A in the study group were higher than those in the control group at admission,significant difference(P<0.05).On admission in patients with severe HbA1c,Sema7A levels were higher than those of moderate and mild patients,and the levels of HbA1c,Sema7A levels in moderate patients were higher than those in mild patients,significant difference(P<0.05).Spearman analysis showed that the levels of HbA1c and Sema7A were positively correlated with the degree of coronary artery stenosis in coronary heart disease patients at admission(r=0.512,0.468,P<0.05).The proportion of diabetes mellitus,hypertension,degree of coronary stenosis,number of stents≥2,main stent diameter<3.5 mm,main stent length≥30 mm,HbA1c and Sema7

关 键 词：冠心病 糖化血红蛋白 信号蛋白7A 经皮冠状动脉介入治疗 狭窄程度 支架内再狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]