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围手术期细胞因子水平对急性心肌梗死患者支架内再狭窄风险的预测价值。

Predictive Value of Perioperative Cytokine Levels on the Risk for In-Stent Restenosis in Acute Myocardial Infarction Patients.

机构信息

Department of Cardiology, The People's Hospital of Cangnan, Wenzhou 325800, Zhejiang Province, China.

Department of Dispensary Pharmacy, Cangnan Maternal and Child Health Hospital, Wenzhou 325800, Zhejiang Province, China.

出版信息

Contrast Media Mol Imaging. 2022 Apr 23;2022:7832564. doi: 10.1155/2022/7832564. eCollection 2022.

Abstract

To investigate the value of perioperative cytokine levels in predicting the risk for in-stent restenosis in patients with acute myocardial infarction. 452 patients with acute myocardial infarction admitted to our hospital between June 2018 and June 2020 were prospectively selected as subjects. All patients underwent percutaneous coronary intervention. The baseline data of the patients were collected. Venous blood was taken before, 24 hours, and 3 days after the operation to detect the levels of related cytokines. Follow-up was performed for 1 year. The patients were assigned to restenosis and nonrestenosis groups according to the presence and absence of restenosis. Multivariate logistic analysis was used to explore the influencing factors of the risk for in-stent restenosis in patients with acute myocardial infarction. By July 1, 2021, 449 cases had been followed up. Of them, 44 cases suffered from in-stent restenosis and 405 cases did not affect in-stent restenosis. The incidence of in-stent restenosis was 9.80%. Before, 24 hours, and 3 days after the operation, the lipoprotein-associated phospholipase A2 (Lp-PLA2) level was significantly higher in the restenosis group than that in the nonrestenosis group. At 3 days after the operation, the interleukin 6 (IL-6) level was significantly higher in the restenosis group than that in the nonrestenosis group ( < 0.05). Multivariate logistic analysis displayed that Lp-PLA2 level preoperatively (OR = 1.048, 95% CI 1.029-1.068), Lp-PLA2 level 24 hours postoperatively (OR = 1.013, 95% CI 1.007-1.019), Lp-PLA2 level 3 days postoperatively (OR = 1.032, 95% CI 1.015-1.048), and IL-6 level 3 days postoperatively (OR = 1.020, 95% CI 1.000-1.040) were risk factors for in-stent restenosis (all  < 0.05). IL-6 and Lp-PLA2 levels can predict the risk for in-stent restenosis in patients with acute myocardial infarction in the perioperative period.

摘要

探讨围手术期细胞因子水平对急性心肌梗死患者支架内再狭窄风险的预测价值。前瞻性选取 2018 年 6 月至 2020 年 6 月我院收治的 452 例急性心肌梗死患者作为研究对象。所有患者均行经皮冠状动脉介入治疗。采集患者的基线资料,分别于术前、术后 24 小时、术后 3 天采集静脉血,检测相关细胞因子水平。随访 1 年。根据是否发生支架内再狭窄,将患者分为再狭窄组和非再狭窄组。采用多因素 logistic 分析探讨急性心肌梗死患者支架内再狭窄的风险影响因素。截至 2021 年 7 月 1 日,共 449 例患者获得随访,其中 44 例发生支架内再狭窄,405 例未发生支架内再狭窄,支架内再狭窄发生率为 9.80%。再狭窄组患者术前、术后 24 小时、术后 3 天脂蛋白相关磷脂酶 A2(Lp-PLA2)水平均显著高于非再狭窄组(均  < 0.05);术后 3 天,再狭窄组白细胞介素 6(IL-6)水平显著高于非再狭窄组(均  < 0.05)。多因素 logistic 分析显示,术前 Lp-PLA2 水平(OR=1.048,95%CI 1.029-1.068)、术后 24 小时 Lp-PLA2 水平(OR=1.013,95%CI 1.007-1.019)、术后 3 天 Lp-PLA2 水平(OR=1.032,95%CI 1.015-1.048)、术后 3 天 IL-6 水平(OR=1.020,95%CI 1.000-1.040)是支架内再狭窄的危险因素(均  < 0.05)。IL-6 和 Lp-PLA2 水平可预测急性心肌梗死患者围手术期支架内再狭窄的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcb0/9056250/0669f516d7ca/CMMI2022-7832564.001.jpg

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