1-磷酸鞘氨醇及脂联素在支架内再狭窄患者中的预测价值

目的：探讨1‐磷酸鞘氨醇（S1P）及脂联素在冠状动脉支架植入术后的预测价值。方法选择经复查冠脉造影后证实为支架内再狭窄患者50例为再狭窄组，选取同时期支架内无再狭窄者50例为对照组，收集研究对象的临床相关资料，分别检测其血清1‐磷酸鞘氨醇（S1P）、HDL‐S1P、脂联素及IL‐18水平，分析其与支架内再狭窄的相关性。结果与对照组比较，再狭窄组血清总S1P水平更低[（96．10±26．33）ng／mLvs．（113．40±32．72）ng／mL，P＜0．01]，HDL‐S1P水平明显降低[（32．81±10．02）ng／mLvs．（42．72±11．75）ng／mL，P＜0．01]，脂联素水平也明显降低[（7．38±2．11）mg／Lvs．（9．25±3．29）mg／L，P＜0．01]，而两组间IL‐18水平则差异无统计学意义[（258．15±82．19）ng／Lvs．（224．98±84．15）ng／L，P＞0．05]；脂联素与S1P（r＝0．712，P＜0．05）及HDL‐S1P（r＝0．821，P＜0．01）之间均呈正相关。结论S1P及脂联素是冠脉支架内再狭窄的独立预测因素，相对较高的S1P及脂联素浓度能降低经皮冠状动脉介入治疗（PCI）术后患者支架内再狭窄的风险。

The predictive values of sphingosine-1-phosphate and adiponectin in patients with in-stent restenosis

Objective To investigate the predictive value of sphingosine‐1‐phosphate (S1P) and adiponectin after coronary stent implantation .Methods Fifty patients confirmed by coronary angiography with in‐stent restenosis were selected as in‐stent resteno‐sis group while 50 patients without in‐stent restenosis were chose as control group .All cases were detected with the density of their serum S1P ,HDL‐S1P ,adiponectin and IL‐18 and analyzed relevance to in‐stent restenosis .Results Compared with the control group ,serum S1P in in‐stent restenosis group were lower [ (96 .10 ± 26 .33)ng/mL vs .(113 .40 ± 32 .72)ng/mL ,P<0 .01] ,and the levels of HDL‐S1P and adiponectin were also significant lower [(32 .81 ± 10 .02)ng/mL vs .(42 .72 ± 11 .75)ng/mL ,P< 0 .01 ;(7 .38 ± 2 .11)mg/L vs .(9 .25 ± 3 .29)mg/L ,P< 0 .01] .IL‐18 levels between the two groups had no significantly difference [(258 .15 ± 82 .19)ng/L vs .(224 .98 ± 84 .15)ng/L ,P>0 .05] .Adiponectin showed a positive correlation between S1P (r=0 .712 , P<0 .05) and HDL‐S1P (r=0 .821 ,P<0 .01) .Conclusion S1P and adiponectin could be independent predictive factor of coronary stent restenosis ,and high concentrations of S1P and adiponectin may reduce risk of in‐stent restenosis in patients with stenting per‐cutaneous coronary intervention (PCI) .