实用心电与临床诊疗2025，Vol.34Issue(4)：501-507,7.DOI:10.13308/j.issn.2097-5716.2025.04.005
急性ST段抬高型心肌梗死患者EFT、血清SFRP5和Wnt5a水平变化及其与PCI术后支架内再狭窄的关系
Changes of EFT,serum SFRP5 and Wnt5a levels in patients with acute ST-segment elevation myocardial infarction,and their association with in-stent restenosis after PCI
摘要
Abstract
Objective To explore the relationship between epicardial fat thickness(EFT),serum secreted frizzled-related protein 5(SFRP5),wingless-type MMTV integration site family member 5a(Wnt5a),and in-stent restenosis(ISR)in patients with acute ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods A total of 128 STEMI patients who had undergone emergency PCI were enrolled.After a 12-month follow-up,they were divided into a non-ISR group(80 cases)and an ISR group(48 cases)based on coronary angiography results.The general data between the two groups were compared,as well as the EFT before discharge and 1 month after surgery,and the serum levels of SFRP5 and Wnt5a measured before surgery and 1 month postoperatively.The differences in the levels of these indicators among patients with varying degrees of coronary artery lesions were also examined.Pearson correlation analysis was used to evaluate the association between EFT and serum levels of SFRP5 and Wnt5a 1 month after surgery.Multivariate Logistic regression analysis was applied to identify the risk factors of ISR in STEMI patients after PCI.ROC curve analysis was used to assess the predictive value of EFT,and serum SFRP5 and Wnt5a levels for ISR.Results The EFT values of the ISR group before discharge and 1 month after surgery were both greater than those of the non-ISR group(all P＜0.01).The serum SFRP5 level of the ISR group was lower than that of the non-ISR group 1 month after surgery,while the serum Wnt5a level was higher(all P＜0.01).Compared to pre-operative levels,serum SFRP5 levels increased 1 month after surgery in the non-ISR group but decreased in the ISR group(both P＜0.05).Serum Wnt5a levels showed a mild increase 1 month after surgery compared to pre-operative levels in the non-ISR group,but increased significantly in the ISR group(both P＜0.05).The serum SFRP5 level 1 month after surgery was significantly lower in the three-vessel disease group than that in the single-or two-vessel disease groups(P＜0.05).EFT 1 month after surgery showed a negative correlation with SFRP5 and a positive correlation with Wnt5a.Both univariate Logistic regression analysis and Logistic regression analysis adjusted for factors such as age and BMI demonstrated that EFT,and serum SFRP5 and Wnt5a levels 1 month after surgery were independent influencing factors for ISR.ROC curve analysis revealed that the combination of these three markers yielded an AUC value of 0.906,which was higher than that of detection with any single indicator.Conclusion Increased EFT,decreased serum SFRP5,and elevated serum Wnt5a 1 month after surgery are closely related to ISR in STEMI patients after PCI.Early detection of these markers facilitates the prediction of ISR,and the combined detection offers superior predictive value.关键词
急性ST段抬高型心肌梗死/心外膜脂肪厚度/分泌型卷曲相关蛋白5/无翅型MMTV整合位点家族成员5a/支架内再狭窄Key words
acute ST-segment elevation myocardial infarction/epicardial fat thickness/secreted frizzled-related protein 5/wingless-type MMTV integration site family member 5a/in-stent restenosis分类
医药卫生引用本文复制引用
丁晓军,张友明,龚军辉,郝英才,刘育松,宋雨姝,朱红涛..急性ST段抬高型心肌梗死患者EFT、血清SFRP5和Wnt5a水平变化及其与PCI术后支架内再狭窄的关系[J].实用心电与临床诊疗,2025,34(4):501-507,7.基金项目
南通大学临床医学专项科研基金重点项目(2024JZ015) （2024JZ015）
镇江市科技计划项目(市重点研发计划-社会发展)(SH2023023) （市重点研发计划-社会发展）
