标题：急性心肌梗死PCI术后支架内再狭窄患者的CRP、Hcy、CysC、NT-proBNP、LDL-C变化及临床意义

      作者：谈昀 1，马兰香 2，张树苗 1，田娇 1，原平利 2，胡建库 2，李芳 1    武警陕西省总队医院检验与病理科 1、特色专业二科 2，陕西 西安 710054

      卷次： 2022年33卷14期

      【摘要】 目的 探讨急性心肌梗死(AMI)经皮冠状动脉介入(PCI)术后支架内再狭窄(ISR)患者的C反应蛋白(CRP)、同型半胱氨酸(Hcy)、胱抑素C (CysC)、N端B型脑钠肽前体(NT-proBNP)、低密度脂蛋白胆固醇(LDL-C)变化及临床意义。方法 回顾性分析武警陕西省总队医院2016年1月至2021年1月收治的300例AMI患者PCI术后的临床资料，根据复查造影有无 ISR分为对照组(n=150，无 ISR)和观察组(n=150，有 ISR)。比较两组患者的CRP、Hcy、CysC、NT-proBNP、LDL-C水平，采用Logistic回归分析诱导 ISR发生的独立因素，采用Pearson法分析 ISR与上述各因子间的相关性。结果 观察组患者的 CRP、Hcy、CysC、NT-proBNP、LDL-C水平分别为(37.31±3.31) mg/L、(23.41±3.21) μmol/L、(1.61±0.41) mg/L、(871.31±28.98) ng/L、(2.97±0.46) mmol/L，明显高于对照组的(18.56±2.69) mg/L、(17.51±2.89) μmol/L、(1.01±0.21) mg/L、(587.41±31.37) ng/L、(2.16±0.31) mmol/L，差异均有统计学意义(P<0.05)；经Logistic回归分析结果显示：CRP、Hcy、CysC、NT-proBNP、LDL-C是导致AMI患者 PCI术后 ISR的独立影响因素(P<0.05)；经Pearson相关性分析结果显示：AMI患者PCI术后 ISR与CRP、Hcy、CysC、NT-proBNP、LDL-C均呈正相关(r=0.412，0.571，0.721，0.412，0.723，P<0.05)。结论 血清CRP、Hcy、CysC、NT-proBNP、LDL-C是诱导AMI患者PCI术后 ISR的独立影响因素，密切监测上述指标变化有助于 ISR的防治。
      【关键词】 急性心肌梗死；经皮冠状动脉介入术；支架内再狭窄；C反应蛋白；同型半胱氨酸；胱抑素C；N端B型脑钠肽前体；临床意义
      【中图分类号】 R542.2+2 【文献标识码】 A 【文章编号】 1003—6350（2022）14—1799—04

Changes and clinical significance of CRP, Hcy, CysC, NT-proBNP, and LDL-C in acute myocardial infarctionpatients with in stent restenosis after percutaneous coronary intervention.
TAN Yun 1, MA Lan-xiang 2, ZHANGShu-miao 1, TIAN Jiao 1, YUAN Ping-li 2, HU Jian-ku 2, LI Fang 1. Department of Laboratory and Pathology 1, Departmentof Characterized Specialty Ⅱ 2, Shaanxi Provincial General Hospital of Armed Police, Xi'an 710054, Shaanxi, CHINA
【Abstract】 Objective To investigate the changes and clinical significance of C-reactive protein (CRP), homo-cysteine (Hcy), Cystatin C (CysC), N-terminal pro brain natriuretic peptide (NT-proBNP), and low density lipoproteincholesterol (LDL-C) in acute myocardial infarction (AMI) patients with in stent restenosis (ISR) after percutaneous coro-nary intervention (PCI). Methods The clinical data of 300 AMI patients treated in Shaanxi Provincial General Hospitalof Armed Police from January 2016 to January 2021 after PCI were analyzed retrospectively. According to whether therewas ISR in the re-examination of angiography, the patients were divided into a control group (n=150, without ISR) andan observation group (n=150, with ISR). The levels of CRP, Hcy, CysC, NT-proBNP, and LDL-C were compared be-tween the two groups. The independent factors inducing ISR were analyzed by logistic regression, and the correlation be-tween ISR and the above factors was analyzed by Pearson method. Results The levels of CRP, Hcy, CysC, NT-proB-NP, and LDL-C in the observation group were (37.31±3.31) mg/L, (23.41±3.21) μmol/L, (1.61±0.41) mg/L, (871.31±28.98) ng/L, (2.97±0.46) mmol/L, which were significantly higher than (18.56±2.69) mg/L, (17.51±2.89) μmol/L, (1.01±0.21) mg/L, (587.41±31.37) ng/L, and (2.16±0.31) mmol/L in the control group (P<0.05). Logistic regression analysisshowed that CRP, Hcy, CysC, NT proBNP, and LDL-C were independent factors leading to ISR after PCI in patientswith AMI (P<0.05). Pearson correlation analysis showed that ISR was positively correlated with CRP, Hcy, CysC,NT-proBNP, and LDL-C in patients with AMI after PCI (r=0.412, 0.571, 0.721, 0.412, 0.723, P<0.05). Conclusion SerumCRP, Hcy, CysC, NT-proBNP, and LDL-C are independent influencing factors of ISR after PCI in patients with inducedAMI. Close monitoring of the changes of the above indexes is helpful for the prevention and treatment of ISR.
      【Key words】 Acute myocardial infarction; Percutaneous coronary intervention; In stent restenosis; C-reactiveprotein; Homocysteine; Cystatin C; N-terminal B-type brain natriuretic peptide precursor; Clinical significance