血清S100A12联合钙化特征评分对老年急性非ST段抬高型心肌梗死病人经皮冠状动脉介入治疗术后支架内再狭窄的预测价值

doi:10.3969/j.issn.1003-9198.2021.09.017

摘要/Abstract

摘要： 目的研究血清S100A12联合钙化特征评分对老年急性非ST段抬高型心肌梗死(NSTEMI)病人经皮冠状动脉介入治疗(PCI)术后支架内再狭窄(ISR)的预测价值。方法选取2017年1月至2018年10月我院心内科收治的220例行PCI术的NSTEMI病人为研究对象,以PCI术后1年内是否发生ISR分为ISR组(34例)和对照组(186例)。收集病人的临床相关资料;采用血管内超声检查病人血管内斑块的相关特征(包括是否钙化病变、钙化长度、钙化弧度、钙化斑块类型),并计算钙化特征评分;采用ELISA法检测病人的血清S100A12水平。采用单因素分析和多因素Logistic回归分析PCI术后发生ISR的危险因素;采用ROC曲线分析钙化特征评分与血清S100A12水平及其联合作用对PCI术后ISR的预测价值。结果 2组病人各钙化特征、钙化特征评分及血清S100A12水平差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,钙化特征评分较高、血清S100A12水平较高、病变长度较大、钙化病变、钙化长度较大、钙化弧度较大及浅表型钙化均为PCI术后ISR的独立危险因素。ROC曲线分析显示,钙化特征评分、血清S100A12水平对PCI术后ISR的预测价值均较高,AUC分别为0.738(0.626～0.870)、0.736(0.621～0.873),且二者联合应用的评估价值更高,AUC为0.835(0.718～0.971)。结论钙化特征评分和血清S100A12蛋白水平与PCI术后ISR的发生关系密切,可作为PCI术后ISR的独立预测因素,二者联合检测较单一指标对预测ISR发生的评估价值更高。

关键词: 急性非ST段抬高型心肌梗死, 经皮冠状动脉介入治疗, 再狭窄, 钙化, S100A12, 老年人

Abstract: Objective To study the predictive value of serum S100A12 combined with calcification characteristic score for in-stent restenosis (ISR) after percutaneous coronary intervention (PCI) in the elderly patients with acute non-ST elevation myocardial infarction (NSTEMI). Methods A total of 220 elderly patients with NSTEMI who were treated by PCI in the Department of Cardiology of our hospital from January 2017 to October 2018 were selected. According to whether ISR occurred within one year after PCI, the patients were divided into ISR group and control group, with 34 cases and 186 cases respectively. The clinical data of the patients were collected, the characteristics of the plaque (including calcification, calcification length, calcification radian, calcification plaque type) were observed by intravascular ultrasound, and the calcification characteristic score was calculated. The level of serum S100A12 was measured by enzyme-linked immunosorbent assay. The risk factors for ISR after PCI were analyzed by univariate analysis and multivariate Logistic regression. The predictive value of calcification score, serum S100A12 and the combination for ISR after PCI was analyzed by receiver operating characteristic (ROC) curve. Results There were significant differences in calcification characteristics, calcification characteristics score and serum S100A12 level between the two groups (P<0.05). Multivariate Logistic regression analysis showed that high calcification characteristics score, high serum S100A12 level, long lesion length, calcification, long calcification length, large calcification radian and superficial calcification were the independent risk factors for ISR after PCI. ROC curve analysis showed that calcification characteristic score and serum S100A12 level had high value in predicting ISR after PCI, and the area under the cure (AUC) was 0.738 (0.626-0.870) and 0.736 (0.621-0.873), respectively. The combination of the two indexes showed higher value in predicting ISR after PCI, with an AUC of 0.835 (0.718-0.971). Conclusions Calcification characteristic score and serum S100A12 level are closely related to the occurrence of ISR after PCI, which can be used as independent influencing factors for ISR after PCI. The joint detection of the two indexes is more valuable than the single index in predicting ISR after PCI.

Key words: non-ST segment elevation myocardial infarction, percutaneous coronary intervention, restenosis, calcification, S100A12, aged

中图分类号:

R 541.6

张正楠. 血清S100A12联合钙化特征评分对老年急性非ST段抬高型心肌梗死病人经皮冠状动脉介入治疗术后支架内再狭窄的预测价值[J]. 实用老年医学, 2021, 35(9): 962-966.

ZHANG Zheng-nan. Predictive value of serum S100A12 combined with calcification characteristic score for in-stent restenosis after percutaneous coronary intervention in elderly patients with acute non-ST segment elevation myocardial infarction[J]. Practical Geriatrics, 2021, 35(9): 962-966.

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