脂蛋白(a)联合全身炎症反应指数对冠心病患者PCI术后支架内再狭窄的预测价值

The predictive value of lipoprotein a combined with systemic inflammatory response index for in-stent restenosis in patients with coronary heart disease after PCI

摘要:

目的]探讨脂蛋白(a)[Lp(a)]与全身炎症反应指数(SIRI)联合应用对冠心病患者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]收集2012年5月—2024年12月在新疆医科大学第一附属医院心血管内科接受PCI术并于术后半年复查冠状动脉造影的770例冠心病患者的临床资料。根据造影结果将患者分为ISR组(n＝194)和非ISR组(n＝576)。通过多因素Logistic回归和随机森林模型对ISR的独立危险因素进行分析。最终纳入分析的危险因素,包括糖化血红蛋白、SIRI、Lp(a)、淋巴细胞计数、载脂蛋白A1(ApoA1)及残余胆固醇。[结果]ISR组的Lp(a)和SIRI水平均显著高于非ISR组(P＜0.05)。ROC曲线分析显示,Lp(a)和SIRI联合指标的曲线下面积为0.789,高于单一指标Lp(a)的0.652和SIRI的0.778。[结论]Lp(a)和SIRI是PCI术后ISR发生的独立危险因素,Lp(a)和SIRI联合能更好地预测ISR的发生。

Abstract:

Aim To investigate the predictive value of lipoprotein(a) [Lp(a)] combined with systemic inflammatory response index (SIRI) on in-stent restenosis (ISR) after percutaneous coronary intervention (PCI) in patients with coronary heart disease. Methods The clinical data of 770 patients with coronary heart disease who underwent PCI in the Department of Cardiovascular Medicine of the First Affiliated Hospital of Xinjiang Medical University from May 2012 to December 2024 and underwent coronary angiography six months after surgery were collected. According to the imaging results, the patients were divided into ISR group (n＝194) and non-ISR group (n＝576). Multivariate Logistic regression and random forest model were used to analyze the independent risk factors of ISR. Risk factors included in the analysis were glycated hemoglobin, SIRI, Lp(a), lymphocyte count, apolipoprotein A1 (ApoA1) and residual cholesterol. Results The levels of Lp(a) and SIRI in the ISR group were significantly higher than those in the non-ISR group (P＜0.05). ROC curve analysis showed that the area under the curve of the combined indicator of Lp(a) and SIRI was 0.789, which was higher than the 0.652 of the single indicator Lp(a) and 0.778 of SIRI. Conclusion Lp(a) and SIRI are independent risk factors for the occurrence of ISR after PCI, and the combination of Lp(a) and SIRI can better predict the occurrence of ISR.