2型糖尿病患者血清半乳糖凝集素-3水平与冠脉支架内狭窄的关系

目的探讨2型糖尿病合并冠心病患者血清半乳糖凝集素-3(Galectin-3)与冠脉支架内狭窄(ISR)关系。方法研究对象选取2015年1月—2016年1月期间浙江医院住院治疗的2型糖尿病合并冠心病且既往药物洗脱支架(DES)植入的患者,根据复查冠脉造影的结果,分支架内狭窄(ISR)组与非ISR组,采用多因素logistic回归分析临床资料与ISR的关系。结果入选357例患者,其中ISR组共36例(10.1%)。与非ISR组相比,ISR组患者在年龄、吸烟患者比例、血清Galectin-3水平更高,支架长度更长,植入支架直径更小,差异有统计学意义(P<0.05)。多因素logistic回归分析结果表明,年龄(OR=1.087,95%CI:1.038～1.134,P<0.001)、支架长度(OR=1.078,95%CI:1.012～1.103,P<0.001)、支架直径(OR=0.425,95%CI:0.243～0.708,P<0.001)及血清Galectin-3水平(OR=1.074,95%CI:1.016～1.121,P<0.001)是ISR的独立危险因素。此外,血清Galectin-3水平与ISR类型相关。结论高血清Galectin-3水平增加了2型糖尿病患者ISR发生的风险,可能是导致ISR的独立危险因素,这为血清学标记物应用于评估冠脉病变程度提供了新思路。

Relationship between serum Galectin-3 level and in-stent restenosis in patients with type 2 diabetes mellitus

Objective To investigate the relationship between serum galectin-3 and in-stent coronary stenosis (ISR) in patients with type 2 diabetes mellitus and coronary heart disease. Methods Patients with type 2 diabetes mellitus complicated with coronary heart disease and previous drug-eluting stent (DES) implantation treated in Zhejiang Hospital from January 2015 to January 2016 were included. According to the results of coronary angiography, all patients were classified into ISR group and non-ISR group. The relationship between clinical data and ISR was analyzed by multivariate logistic regression. Results A total of 357 patients were enrolled, of whom 36 were in group ISR (10.1%). Compared with non-ISR group, ISR group had higher age, proportion of smokers, serum Galectin-3 level, longer stent length and smaller stent diameter (P<0.05). Multivariate logistic regression analysis showed that age (OR=1.087, 95% CI: 1.038-1.134, P<0.001), stent length (OR=1.078, 95% CI: 1.012-1.103, P<0.001), stent diameter (OR=0.425, 95% CI: 0.243-0.708, P<0.001) and serum Galectin-3 level (OR=1.074, 95% CI: 1.016-1.121, P<0.001) were independent risk factors for ISR. In addition, serum Galectin-3 level was correlated with ISR type. Conclusion High serum Galectin-3 level increases the risk of ISR in type 2 diabetes mellitus, which may be an independent risk factor for ISR. This provides a new idea for the application of serological markers in assessing the severity of coronary artery disease.