血清Hs-CRP及CTRP9与冠脉支架介入术后再狭窄的相关性研究

摘要

目的:探讨血清Hs-CRP、脂肪细胞因子Clq/肿瘤坏死因子相关蛋白(Clq/TNF-Related Protein 9,CTRP 9)与冠状动脉药物洗脱支架植入术后支架内再狭窄(in-stent restenosis,ISR)的相关性研究.方法:选择本院心内科确诊为不稳定型心绞痛的356例住院患者进行雷帕霉素药物洗脱支架植入术,术后12 ～18个月再次入院行冠状动脉造影检查,根据造影结果评价有无ISR.并测定入组患者再次入院造影检查时血清中CTRP 9及Hs-CRP等指标.结果:(1)356例患者中有63例发生ISR,发病率为17.70％;(2)单因素分析示,ISR和非ISR两组间Hs-CRP、CTRP 9、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、冠状动脉Gensini积分、支架数量、支架直径、支架长度及糖尿病病史差异有统计学意义(P＜0.05);(3)多因素Logistic回归分析示,Hs-CRP、支架数量及糖尿病病史是术后发生ISR的独立危险因素,而较大的支架直径及CTRP 9水平是其保护因素(P＜0.05).结论:血清Hs-CRP是冠状动脉发生ISR的独立危险因素,而CTRP 9是其保护因素.%Objective:To determine the relationship between serum Hs-CRP,Clq/TNF-Related Protein 9 (CTRP 9) and instent restenosis (ISR) after drug-eluting stent based on percutaneous intervention.Methods:356 patients with unstable angina who diagnosis of cardiovascular center clinic in our hospital were treated with drug-eluting stents implantation,and coronary angiography was performed again 12 ～ 18 months after the operation,and ISR was evaluated according to the results of angiography.The serum levels of CTRP 9 and Hs-CRP were also measured.Results:A total of 356 patients were enrolled,including 63 patients had ISR,the incidence of ISR was 17.70％.Univariate analysis showed that Hs-CRP,CTRP 9,LDL-C,TC,coronary Gensini integrals,stent number,stent diameter,stent length and diabetes were significantly different between the two groups (P ＜ 0.05).Multi-factor Logistic regression indicated that Hs-CRP,diabetes and stent number were the independent risk factors for the onset of ISR,and longer stent diameter and CTRP 9 was a protective factor (P ＜0.05).Conclusion:Serum Hs-CRP is independent risk factors for the development of target lesion occurred ISR,but CTRP 9 is a protective factor for ISR.