Relationships between Serum Concentrations of Secreted Frizzled Related Protein 5 and Osteoprotegerin with Revascularization of Severe Instent Restenosis after Percutaneous Coronary Intervention in Patients with Coronary Heart Disease
Relationships between Serum Concentrations of Secreted Frizzled Related Protein 5 and Osteoprotegerin with Revascularization of Severe Instent Restenosis after Percutaneous Coronary Intervention in Patients with Coronary Heart Disease
程诚 1王鑫 1李艳 1黄艺芳1
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作者信息
1. 中山市火炬开发区人民医院心内科,广东 中山 528437
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摘要
目的 探讨血清分泌型卷曲相关蛋白5(secreted frizzled related protein 5,Sfrp5)和骨保护素(osteoprote-gerin,OPG)与冠状动脉粥样硬化性心脏病(冠心病)患者行经皮冠状动脉介入(PCI)治疗后发生严重支架内再狭窄(instent restenosis,ISR)再次血运重建的关系.方法 选取中山市火炬开发区人民医院2018年1月至2021年12月收治的冠心病行PCI治疗后并再次复查冠状动脉造影(复查时间≥6个月)患者389例的临床治疗.根据患者是否需再次血运重建分为再次重建组(n=83)和非再次重建组(n=306),分析两组患者基线资料及血清Sfrp5、OPG浓度,采用Cox风险比例回归分析血清Sfrp5、OPG浓度对PCI治疗后发生严重ISR再次血运重建的影响.结果 再次重建组患者的糖尿病病史、糖化血红蛋白、超敏C-反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、SYNTAX评分及血清OPG浓度高于非再次重建组,差异有统计学意义(P<0.05);再次重建组患者血清Sfrp5浓度低于非再次重建组,差异有统计学意义(P<0.05).Cox风险比例模型分析结果发现,血清Sfrp5 浓度(β=-0.531,OR=0.588,95%CI=0.370～0.936)、血清OPG浓度(β=1.275,OR=3.579,95%CI=1.309～9.781)、SYNTAX评分(β=1.113,OR=3.043,95%CI=1.094～8.467)是PCI治疗后发生严重ISR再次血运重建的影响因素.结论 血清Sfrp5和OPG浓度与冠心病患者行PCI治疗后发生严重ISR再次血运重建密切相关,血清Sfrp5浓度降低、血清OPG浓度升高可能增加再次血运重建风险.
Abstract
Objectives To investigate the relationships between serum concentrations of secreted frizzled related protein 5(Sfrp5)and osteoprotegerin(OPG)and severe instent restenosis(ISR)revascularization after percutaneous coronary intervention(PCI)in patients with coronary heart disease.Methods Totally 389 patients with coronary heart disease admitted to Zhongshan Torch Development Zone Hospital from January 2018 to December 2021 who underwent PCI and underwent coronary angiography again≥6 months later were selected.The patients were divided into two groups according to whether they need to undergo revascularization:revascularization group(n=83)and non-revascularization group(n=306).Baseline data and serum concentrations of Sfrp5 and OPG were analyzed in both groups.Cox risk proportional regression was used to analyze the impact of serum concentrations of Sfrp5 and OPG on revascularization following severe ISR after PCI.Results The history of diabetes,glycosylated hemoglobin,high-sensitivity C-reactive protein(hs-CRP),SYNTAX scores and serum concentration of OPG in revascularization group were higher than those in non-revascularization group(P<0.05).The serum concentration of Sfrp5 in revascularization group were lower than that in non-revascularization group(P<0.05).Cox risk proportional model analysis found that serum concentration of Sfrp5(β=-0.531,OR=0.588,95%CI=0.370-0.936),serum concentration of OPG(β=1.275,OR=3.579,95%CI=1.309-9.781),SYNTAX score(β=1.113,OR=3.043,95%CI=1.094-8.467)were risk factors for severe ISR revascularization after PCI.Conclusions Serum concentrations of Sfrp5 and OPG are closely related to the occurrence of severe ISR revasculariza-tion after PCI in patients with coronary heart disease.And serum concentration of Sfrp5 decreasing and serum concentra-tion of OPG increasing may enhance the risk of revascularization.
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