血清CD147水平对经皮冠状动脉介入术干预非梗死相关动脉预后评估的价值
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(1.西安市第九医院血管介入科,陕西省西安市 710054;2.西安市中医医院肿瘤科,陕西省西安市 710021)

作者简介:

彭怀玉,主治医师,研究方向为微创介入、血管腔内介入,E-mail为p2h02o8@163.com。通信作者孙继虎,主治医师,研究方向为微创血管介入,E-mail为jduhz33@163.com。

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陕西省自然科学基础研究计划项目(2019JM-571)


The value of serum CD147 level in evaluating the prognosis of non-infarction related artery after percutaneous coronary intervention
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Affiliation:

1.Department of Vascular Intervention, Xi'an Ninth Hospital, Xi'an, Shaanxi 710054, China;2.Department of Oncology, Xi'an Hospital of Traditional Chinese Medicine, Xi'an, Shaanxi 710021, China)

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    摘要:

    目的 探讨血清CD147水平对经皮冠状动脉介入术(PCI)干预非梗死相关动脉(non-IRA)预后评估的价值。方法 选取本院2017年3月—2019年3月收治的103例合并多支血管病变的ST段抬高型心肌梗死(STEMI)患者103例,患者均在PCI成功开通IRA后的3~7天行non-IRA PCI治疗。根据术后6个月患者是否发生主要不良心血管事件(MACE)分为两组:非MACE组75例,MACE组28例。依据Killip心功能分级标准进行分级;检查超声心动图并记录左心室射血分数(LVEF);采用Judkins法行冠状动脉造影检查,并记录血管狭窄情况。比较两组一般资料、血清生物化学指标差异;绘制ROC曲线,评估血清CD147水平对STEMI患者行多支血管PCI后发生MACE的诊断价值;采用COX回归模型分析STEMI患者行多支血管PCI后发生MACE的危险因素。结果与非MACE组相比,MACE组高脂血症比例、Killip Ⅱ~Ⅲ级比例、低密度脂蛋白胆固醇和CD147水平均较高(P<0.05),LVEF较低(P<0.05)。ROC结果显示,血清CD147诊断STEMI患者行多支血管PCI后发生MACE的曲线下面积为0.834,截断值为625.58 ng/L,对应的灵敏度、特异度分别为78.60%、81.30%,约登指数为0.599。COX回归模型结果显示,Killip Ⅱ~Ⅲ级、LVEF<45%、高水平CD147均是STEMI患者行多支血管PCI后发生MACE的独立危险因素(P<0.05)。结论 CD147与STEMI患者行多支血管PCI预后密切相关,对STEMI患者PCI后发生MACE有一定诊断价值,可为行多支血管PCI的STEMI患者的预后评估提供参考依据。

    Abstract:

    Aim To investigate the value of serum CD147 level in evaluating the prognosis of non-infarction related artery (non-IRA) after percutaneous coronary intervention (PCI). Methods 103 patients with ST-segment elevation myocardial infarction (STEMI) complicated with multi-vessel disease admitted to our hospital from March 2017 to March 2019 were selected. All patients were treated with non-IRA PCI 3~7 days after PCI successfully opened IRA. According to whether major adverse cardiovascular event (MACE) occurred 6 months after operation, the patients were divided into two groups:non-MACE group (n=75) and MACE group (n=28). According to Killip cardiac function classification standard, the patients were graded. Echocardiography and left ventricular ejection fraction (LVEF) were recorded. Coronary angiography was performed by Judkins method and the stenosis was recorded. The differences of general information and serum biochemical indexes were compared between the two groups. ROC curve was drawn to evaluate the diagnostic value of serum CD147 level for MACE after multi-vessel PCI in STEMI patients. COX regression model was used to analyze the risk factors of MACE after multi-vessel PCI in STEMI patients. Results Compared with non-MACE group, the proportion of hyperlipidemia, Killip Ⅱ~Ⅲ ratio, low density lipoprotein cholesterol and CD147 levels were higher in MACE group (P<0.05), and LVEF was lower (P<0.05). ROC results showed that the area under curve of serum CD147 in diagnosing MACE after multi-vessel PCI in STEMI patients was 0.834, the cut-off value was 625.58 ng/L, the corresponding sensitivity and specificity were 78.60% and 81.30% respectively, and the Youden index was 0.599. COX regression model showed that Killip Ⅱ~Ⅲ, LVEF<45% and high level CD147 were independent risk factors for MACE after multi-vessel PCI in STEMI patients (P<0.05). Conclusions CD147 is closely related to the prognosis of STEMI patients undergoing multi-vessel PCI. It has a certain diagnostic value for MACE after PCI in STEMI patients, and can provide a reference for the prognosis evaluation of STEMI patients undergoing multi-vessel PCI.

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彭怀玉,钟勇进,高雨蕉,孙继虎.血清CD147水平对经皮冠状动脉介入术干预非梗死相关动脉预后评估的价值[J].中国动脉硬化杂志,2021,29(7):600~604.

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  • 收稿日期:2020-06-17
  • 最后修改日期:2020-08-05
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  • 在线发布日期: 2021-06-28