外周血内皮细胞特异性分子-1、鸢尾素与急性冠状动脉综合征患者PCI术后慢血流或无复流的相关性OA

Objective To investigate the relationship between peripheral blood endothelial cell specific molecule-1(Endocan),Irisin,and the occurrence of slow-flow/no-reflow(SF/NR)after percutaneous coronary intervention(PCI)in patients with acute coronary syndrome(ACS).Methods A total of 215 ACS patients who underwent PCI in Jilin City Hospital of Chemical Industry from January 2021 to March 2024 were selected as the ACS group,and 114 healthy volunteers during the same period were recruited as the control group.ACS patients were further divided into an SF/NR group(71 cases)and a normal blood flow group(144 cases)according to the blood perfusion after PCI.The levels of Endocan and Irisin in peripheral blood were detected.The influencing factors for SF/NR in ACS patients after PCI were analyzed by multivariate Logistic regression,and the predictive value of peripheral blood levels of Endocan and Irisin for SF/NR in ACS patients after PCI were analyzed by receiver operating characteristic(ROC)curve.Results Compared with the control group,the level of Endocan in peripheral blood in the ACS group was significantly higher,and the level of Irisin was significantly lower(t=23.545,-15.047;P<0.01).Among the 215 ACS patients,the incidence of SF/NR after PCI was 33.02％(71/215).Compared to the normal blood flow group,the SF/NR group demonstrated significantly elevated Endocan level and reduced Irisin level in peripheral blood(t=7.953,-8.086;P<0.01).The risk factors for SF/NR in ACS patients after PCI were elevated low density lipoprotein cholesterol[OR(95％CI)=1.234(1.058-1.439)]and elevated Endocan[OR(95％CI)=1.323(1.200-1.458)],while the protective factor was elevated Irisin[OR(95％CI)=0.969(0.957-0.980)].The area under the curve for the prediction of SF/NR in ACS patients after PCI by combination of peripheral blood Endocan and Irisin levels was 0.896(95％CI=0.847-0.933),which was significantly greater than that of single index prediction(Z=4.146,4.167;P<0.01).Conclusion Elevated peripheral blood Endocan and decreased Irisin levels are closely related to SF/NR after PCI in ACS patients.The combination of peripheral blood Endocan and Irisin levels has a high value in predicting SF/NR in ACS patients after PCI.