摘要
目的探讨老年冠状动脉粥样硬化性心脏病(冠心病)患者经皮冠状动脉介入术(PCI)术后支架内再狭窄与转化生长因子β1(TGF-β1)基因多态性的关系。方法选取老年冠心病并行PCI患者198例,随访2年,按是否发生支架内再狭窄分为狭窄组和非狭窄组。术前收集患者基本临床资料,检测血清TGF-β1水平并测定TGF-β1基因型,记录患者随访过程中心肌梗死、心力衰竭、心源性死亡、大出血、再次行PCI例数及血小板反应性、冠脉Gensini评分,使用Logistic回归分析老年冠心病患者PCI术后支架内再狭窄的预测因子。结果狭窄组67例(33.84%)、非狭窄组131例(66.16%)。PCI术前两组年龄、性别、既往史、心功能等基本资料比较差异无统计学意义。狭窄组TGF-β1基因CC型比例高于非狭窄组(P<0.05)。狭窄组血清TGF-β1水平高于非狭窄组,且两组TGF-β1基因CC型患者血清TGF-β1水平均高于CT和TT型患者(P均<0.05)。Logistic多因素回归分析显示,血清TGF-β1水平升高、TGF-β1基因CC型、血小板反应性及Gensini评分是老年冠心病患者PCI术后支架内再狭窄的独立危险预测因子(P均<0.05)。结论老年冠心病患者PCI术后支架内再狭窄与血清TGF-β1水平增高及TGF-β1基因型CC型有关,血清TGF-β1水平升高和TGF-β1基因型CC型增加再狭窄的风险。
Objective To explore the relationship between in-stent restenosis and transforming growth factorβ1(TGF-β1)gene polymorphism after percutaneous coronary intervention(PCI)in elderly patients with coronary heart disease.Methods Totally 198 elderly patients with coronary heart disease undergoing PCI were selected and followed up for 2 years.According to whether in-stent restenosis occurred,they were divided into the stenosis group and non-stenosis group.Before the operation,the basic clinical data of the patients were collected,the serum TGF-β1 level and the TGF-β1 genotype were determined.Myocardial infarction,heart failure,cardiac death,massive hemorrhage,re-PCI,platelet reactivity and coronary Gensini score were recorded.Logistic regression was used to analyze the independent risk factors for stent restenosis in elderly patients with coronary heart disease after PCI.Results There were 67 cases(33.84%)in the stenosis group and 131 cases(66.16%)in the non-stenosis group.There were no significant differences in the age,gender,past history or cardiac function between the two groups before PCI.The proportion of TGF-β1 CC genotype in the stenosis group was higher than that in the non-stenosis group(P<0.05).The level of serum TGF-β1 in the stenosis group was higher than that in the non-stenosis group,and the serum TGF-β1 level in patients with CC genotype was higher than that in patients with CT and TT genotypes(all P<0.05).Logistic multivariate regression analysis showed that the elevated serum TGF-β1 level,TGF-β1 CC genotype,platelet reactivity and Gensini score were independent risk factors for restenosis after PCI in elderly patients with coronary heart disease(all P<0.05).Conclusion In-stent restenosis in elderly patients with coronary heart disease after PCI is associated with increased serum TGF-β1 level and TGF-β1 CC genotype;the elevated serum TGF-β1 level and TGF-β1 CC genotype increase the risk of restenosis.
作者
邹璐
唐敏
戴琰
ZOU Lu;TANG Min;DAI Yan(Liaoyang Central Hospital,Liaoning 111000,China)
出处
《山东医药》
CAS
2020年第25期6-9,共4页
Shandong Medical Journal
基金
辽宁省卫生计生委科研课题(20180101)。
