CAJ | 학술논문

目的：探讨氧化低密度脂蛋白（ox－LDL）、C 反应蛋白（CRP）对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。方法选择行 PCI 术并于术后6个月内接受冠状动脉造影复查的患者186例，其中术后发生 ISR （ISR 组）22例，无 ISR 发生（非 ISR 组）164例。检测两组 PCI 术前和术后血清 ox－LDL、CRP水平。结果 ISR 组和非 ISR 组年龄、性别构成、合并症、血脂水平、血管病变情况等一般资料差异均无统计学意义（P ＞0．05）。 ISR 组 PCI 术后 ox－LDL、CRP 水平明显高于术前（P ＜0．05），而非 ISR 组 PCI 术前和术后ox－LDL、CRP 水平无明显改变（P ＞0．05）。 ISR 组术前、术后 ox－LDL 水平均高于非 ISR 组（P ＜0．05）；术前2组CRP 水平差异无统计学意义（P ＞0．05），术后 ISR 组明显高于非 ISR 组（P ＜0．05）。相关分析显示 ISR 组、非ISR 组无论是 PCI 术前还是 PCI 术后，ox－LDL 与 CRP 均呈正相关[ISR 组：术前、术后 r 值（P 值）分别为0．392（0．020）、0．431（0．010）；非 ISR 组：术前、术后 r 值（P 值）分别为0．382（0．024）、0．526（0．001）]；Logistic回归分析显示术后 ox－LDL[优势比（OR）＝1．27，95％可信区间（CI）：1．05～1．79]和术前 CRP 水平（OR ＝1．82，95％CI：1．68～2．30）是 ISR 的独立危险因子。结论 PCI 术后 ox－LDL 和术前 CRP 水平升高对预测 ISR 发生有一定的临床价值。
목적：탐토양화저밀도지단백（ox－LDL）、C 반응단백（CRP）대경피관상동맥개입치료（PCI）술후지가내재협착（ISR）적예측개치。방법선택행 PCI 술병우술후6개월내접수관상동맥조영복사적환자186례，기중술후발생 ISR （ISR 조）22례，무 ISR 발생（비 ISR 조）164례。검측량조 PCI 술전화술후혈청 ox－LDL、CRP수평。결과 ISR 조화비 ISR 조년령、성별구성、합병증、혈지수평、혈관병변정황등일반자료차이균무통계학의의（P ＞0．05）。 ISR 조 PCI 술후 ox－LDL、CRP 수평명현고우술전（P ＜0．05），이비 ISR 조 PCI 술전화술후ox－LDL、CRP 수평무명현개변（P ＞0．05）。 ISR 조술전、술후 ox－LDL 수평균고우비 ISR 조（P ＜0．05）；술전2조CRP 수평차이무통계학의의（P ＞0．05），술후 ISR 조명현고우비 ISR 조（P ＜0．05）。상관분석현시 ISR 조、비ISR 조무론시 PCI 술전환시 PCI 술후，ox－LDL 여 CRP 균정정상관[ISR 조：술전、술후 r 치（P 치）분별위0．392（0．020）、0．431（0．010）；비 ISR 조：술전、술후 r 치（P 치）분별위0．382（0．024）、0．526（0．001）]；Logistic회귀분석현시술후 ox－LDL[우세비（OR）＝1．27，95％가신구간（CI）：1．05～1．79]화술전 CRP 수평（OR ＝1．82，95％CI：1．68～2．30）시 ISR 적독립위험인자。결론 PCI 술후 ox－LDL 화술전 CRP 수평승고대예측 ISR 발생유일정적림상개치。
Objective To investigate the predictive significance of oxidized low-density lipoproteins (ox-LDL) and C reactive protein (CRP) for in-stent restenosis (ISR) after percutaneous coronary intervention (PCI). Methods A total of 186 patients who were given PCI and followed up for 6 months were enrolled.Of them, 22 patients had ISR(ISR group), while the other 164 patients had not ISR(no-ISR group).The pre-and post-PCI serum ox-LDL and CRP were detected.Results There was no statistical significance between the 2 groups in terms of age, sex, morbidity, serum lipid and vessel lesion(P >0.05).Serum ox-LDL and CRP increased significantly in ISR group at post-PCI compared with pre-PCI (P <0.05), while there was no significant change in no-ISR group (P >0.05).Serum ox-LDL were also higher in ISR group compared with no-ISR group at pre-and post-PCI (P <0.05).There was no statistical significance for CRP level between the 2 groups at pre-PCI (P >0.05).However, the significant increase of CRP level in ISR group compared with no-ISR group was present at post-PCI (P <0.05).Correlation analysis revealed that there was positive correlation between pre-and post-PCI for serum ox-LDL and CRP in both ISR and no-ISR groups [ISR group: r(P) values of pre-and post-PCI were 0.392 (0.020) and 0.431 (0.010); no-ISR group: r(P) values of pre-and post-PCI were 0.382 (0.024) and 0.526 (0.001)].The Logistic regression analysis showed that post-PCI ox-LDL [odds ratio (OR) =1.27, 95% confidence interval (CI): 1.05-1.79] and pre-PCI CRP (OR =1.82,95%CI:1.68-2.30) were independent risk factors of ISR.Conclusions Post-PCI ox-LDL and pre-PCI CRP have certain significance in the prediction of ISR.