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- 2018
半乳糖凝集素-3和基质金属蛋白酶-9与支架内再狭窄的关系
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Abstract:
摘要：目的 探讨半乳糖凝集素-3(Gal-3)和基质金属蛋白酶-9(MMP-9)与支架内再狭窄(ISR)的关系。方法 连续招募434例植入药物涂层支架的冠心病患者，根据随访期复查冠脉造影结果，分为再狭窄组(ISR，41例)和非再狭窄组(NO-ISR，393例)。分析ISR的独立危险因素，按照除Gal-3和MMP-9外的其他危险因素对两组患者进行配对后，比较两组的血清Gal-3和MMP-9水平，并分析其与ISR严重程度的关系。分别根据Gal-3和MMP-9水平不同进行分组，比较各组间主要不良心血管事件(MACEs)的发生率。结果 消除其他因素影响后进行统计学分析，ISR组的血清Gal-3和MMP-9水平均显著高于NO-ISR组(P<0.001)。血清Gal-3及MMP-9水平在Ⅲ型和Ⅳ型再狭窄患者中均显著高于Ⅰ型再狭窄患者(P<0.05)。Gal-3及MMP-9较高浓度组MACEs发生率高于低浓度组(P<0.01)；ISR组MACEs发生率高于NO-ISR组(P<0.05)。结论 MMP-9和Gal-3与ISR发生及其严重程度密切相关，是ISR的独立预测因子。并随着二者的血清浓度的升高，支架术后长期随访的MACEs发生率升高。
ABSTRAST: Objective To investigate the relationship of galectin-3 (Gal-3) and matrix metalloproteinase-9 (MMP-9) with in-stent restenosis (ISR). Methods We consecutively recruited 434 patients who had undergone successful drug eluting stent (DES) implantation. Then we divided them into ISR group (n=41) and NO-ISR group (n=393) according to the results of coronary angiography review. Independent risk factors for ISR were found out by multivariate analysis and the two groups were matched for these factors except for Gal-3 and MMP-9. After elimination of the influence of confounders, serum Gal-3 and MMP-9 were compared between the groups and their relations with the severity of ISR were analyzed. Patients were grouped based on Gal-3 and MMP-9 concentrations and major adverse cardiac events (MACEs) were compared between the two groups. Results After elimination of the influence of confounders, the results showed that serum levels of Gal-3 and MMP-9 were significantly higher in ISR group than in NO-ISR group (P<0.001). Serum levels of Gal-3 and MMP-9 increased with the increased grade of classification. Serum levels of Gal-3 and MMP-9 were obviously higher in classes Ⅲ and Ⅳ ISR than in class Ⅰ (P<0.05). Patients with higher levels of Gal-3 and MMP-9 had a higher incidence of MACEs (P<0.01). ISR group had a higher incidence of MACEs than NO-ISR group (P<0.05). Conclusion Serum levels of Gal-3 and MMP-9 are correlated with ISR and its severity, and they are independent risk factors for ISR. The rate of MACEs during follow-up period was increased with the increased levels of Gal-3 and MMP-9
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