血清内皮素-1、一氧化氮及C反应蛋白水平与下肢动脉硬化闭塞症支架植入术后再狭窄的相关性

李立涛; 曾桂强; 易江枫

doi:10.7619/jcmp.20213387

血清内皮素-1、一氧化氮及C反应蛋白水平与下肢动脉硬化闭塞症支架植入术后再狭窄的相关性

广东省人民医院河源医院介入血管外科, 广东河源, 517000

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中图分类号: R658.3;R543.5
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- 收稿日期: 2021-08-22
- 网络出版日期: 2022-03-10

Relationships of serum endothelin 1, nitric oxide and C-reactive protein levels with restenosis in patients with lower extremity arteriosclerosis obliterans after stent implantation

Department of Interventional Vascular Surgery, Heyuan Hospital of Guangdong Provincial People's Hospital, Heyuan, Guangdong, 517000

摘要

摘要:
目的
探讨血清内皮素-1(ET-1)、一氧化氮(NO)及C反应蛋白(CRP)水平与下肢动脉硬化闭塞症(ASO)患者支架植入术后再狭窄的关系。
方法
回顾性分析行支架植入术治疗的173例ASO患者的临床资料，根据术后1个月是否出现再狭窄将其分为再狭窄组22例和未狭窄组151例。比较2组患者的临床资料，分析再狭窄的危险因素，并采用受试者工作特征(ROC)曲线分析血清ET-1、NO、CRP水平对ASO患者支架植入术后再狭窄的诊断价值。
结果
再狭窄组吸烟、糖化血红蛋白(HbA1c)、ET-1、NO、CRP水平高于未狭窄组，差异有统计学意义(P < 0.05); 多因素Logistic回归分析显示，吸烟、HbA1c≥6%、ET-1≥60 g/L、NO≥32 μmol/L、CRP≥20 mg/L为ASO患者支架植入术后再狭窄的独立危险因素(P < 0.05); ROC曲线显示，血清ET-1、NO、CRP联合诊断ASO患者支架植入术后再狭窄的曲线下面积大于单独检测，差异有统计学意义(P < 0.05)。
结论
ASO支架植入术后再狭窄患者血清ET-1、NO、CRP水平高表达，可能参与术后再狭窄的发生发展。
- 下肢动脉硬化闭塞症 /
- 支架植入 /
- 再狭窄 /
- 内皮素-1 /
- 一氧化氮 /
- C反应蛋白
Abstract:
Objective
To study the relationships of serum endothelin 1 (ET-1), nitric oxide (NO) and C-reactive protein (CRP) levels with restenosis in patients with lower extremity arteriosclerosis obliterans (ASO) after stent implantation.
Methods
A retrospective analysis was performed on the clinical data of 173 patients with ASO treated with stent implantation. The patients were divided into restenosis group (n=22) and non-stenosis group (n=151) according to the presence or absence of restenosis at one month after operation. The clinical data of the two groups were compared, and the risk factors were analyzed. Receiver operating characteristic (ROC) curve was used to analyze the value of serum ET-1, NO and CRP levels in the diagnosis of restenosis in patients with ASO after stent implantation.
Results
The proportion of patients with smoking history, levels of glycated hemoglobin (HbA1c), ET-1, NO and CRP in the restenosis group were higher than those in the non-stenosis group (P < 0.05). Logistic multivariate regression analysis showed that smoking and HbA1c≥6%, ET-1≥60 g/L, NO≥32 μmol/L and CRP≥20 mg/L were independent risk factors for restenosis after STENT implantation in ASO patients (P < 0.05). ROC curve showed that the area under the curve of combined diagnosis of serum ET-1, NO and CRP levels for restenosis in patients with ASO after stent implantation was higher than that of single detection (P < 0.05).
Conclusion
Serum ET-1, NO and CRP levels are higher in ASO patients with restenosis after stent implantation, which indicates that these indicators may be involved in the occurrence and development of restenosis.
- lower extremity arteriosclerosis obliterans /
- stent implantation /
- restenosis /
- endothelin 1 /
- nitric oxide /
- C-reactive protein

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图 1 ET-1、NO、CRP诊断ASO患者支架植入术后再狭窄的ROC曲线

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表 1 再狭窄组和未狭窄组临床资料比较[n(%)](x±s)

指标		再狭窄组(n=22)	未狭窄组(n=151)	t/χ²	P
年龄/岁		55.43±7.26	54.87±7.20	0.340	0.734
性别	男	13(59.09)	80(52.98)	0.288	0.591
	女	9(40.91)	71(47.02)
BMI/(kg/m²)		22.80±4.03	22.91±4.06	0.119	0.906
SBP/mmHg		131.15±20.69	128.52±19.07	0.598	0.551
DBP/mmHg		82.44±15.19	79.60±14.22	0.868	0.387
吸烟		15(68.18)	49(32.45)	10.518	0.001
高血压		10(45.45)	70(46.61)	0.006	0.937
高脂血症		8(36.36)	43(28.48)	0.575	0.448
HbA1c/%		8.90±2.04	5.33±1.86	8.308	< 0.001
TC/(mmol/L)		5.11±1.03	5.02±0.95	0.411	0.682
TG/(mmol/L)		2.03±0.14	1.99±0.10	1.658	0.099
LDL-C/(mmol/L)		3.04±0.22	2.98±0.18	1.418	0.158
ET-1/(ng/L)		68.52±10.33	55.26±7.31	7.503	< 0.001
NO/(μmol/L)		37.90±7.22	30.60±4.52	6.486	< 0.001
CRP/(mg/L)		25.68±6.41	14.62±3.25	12.811	< 0.001
BMI: 体质量指数; SBP: 收缩压; DBP: 舒张压; HbA1c: 糖化血红蛋白; TC: 总胆固醇; TG: 甘油三酯; LDL-C: 低密度脂蛋白胆固醇; ET-1: 内皮素-1; NO: 一氧化氮; CRP: C反应蛋白。

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表 2 支架植入术后再狭窄的多因素分析

变量	β	SE	Wald χ²	P	OR	95%CI
吸烟	0.335	0.112	8.947	0.003	1.398	1.122~1.741
HbA1c	0.345	0.126	7.497	0.006	1.412	1.103~1.808
ET-1	0.401	0.110	13.289	< 0.001	1.493	1.204~1.853
NO	0.405	0.106	14.598	< 0.001	1.499	1.218~1.846
CRP	0.392	0.114	11.824	< 0.001	1.480	1.184~1.850
HbA1c: 糖化血红蛋白; ET-1: 内皮素-1; NO: 一氧化氮; CRP: C反应蛋白。

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血清内皮素-1、一氧化氮及C反应蛋白水平与下肢动脉硬化闭塞症支架植入术后再狭窄的相关性

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Relationships of serum endothelin 1, nitric oxide and C-reactive protein levels with restenosis in patients with lower extremity arteriosclerosis obliterans after stent implantation

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