2型糖尿病下肢血管病变患者介入治疗后血清NLRP3及sVCAM-1水平对再狭窄的意义
Significance of NOD-like receptor thermal protein domain associated protein 3 and soluble vascular cell adhesion molecules-1 levels to restenosis in patients with lower extremity vascular disease of type 2 diabe-tes mellitus after interventional therapy
张继光 1杨贤达 1靳开星1
作者信息
- 1. 056000 邯郸,河北省邯郸市中心医院血管介入科
- 折叠
摘要
目的 探讨2型糖尿病下肢血管病变患者介入治疗后血清NOD样受体蛋白3(NLRP3)及可溶性血管细胞黏附分子-1(sVCAM-1)水平对再狭窄的意义.方法 回顾性分析2022年1月～2023年1月于河北省邯郸市中心医院血管介入科104例成功行血管介入治疗的2型糖尿病下肢血管病变患者的临床资料.根据介入后再狭窄发生情况分为再狭窄组(n=20)和无再狭窄组(n=84),比较两组患者一般资料及介入后24 h血清NLRP3、sVCAM-1水平,采用多因素Logistic回归模型分析再狭窄发生的影响因素;创建受试者工作特征(ROC)曲线,分析血清NLRP3、sVCAM-1检测对再狭窄的预测价值.结果 与无再狭窄组相比,再狭窄组患者2型糖尿病病程、下肢动脉病变长度更长,Fontaine分期Ⅳ期占比、下肢动脉完全闭塞占比及血清糖化血红蛋白(HbA1c)、超敏C反应蛋白(hs-CRP)、NLRP3、sVCAM-1水平更高(P＜0.05);多因素Logistic回归分析显示,下肢动脉完全闭塞、下肢动脉病变长度、HbA1c、NLRP3及sVCAM-1是2型糖尿病下肢血管病变患者介入后再狭窄发生的影响因素(P＜0.05);ROC曲线显示,血清NLRP3、sVCAM-1联合检测对2型糖尿病下肢血管病变患者介入后再狭窄发生的预测价值较高,敏感度为95.00%,特异度为71.43%,ROC曲线下面积为0.929.结论 血清NLRP3、sVCAM-1水平高表达均是2型糖尿病下肢血管病变患者介入治疗后再狭窄发生的危险因素,二者联合检测能提高2型糖尿病下肢血管病变患者介入治疗后再狭窄预测的准确性.
Abstract
Objective To investigate the significance of levels of NOD-like receptor thermal protein domain associated protein 3(NLRP3)and soluble vascular cell adhesion molecules-1(sVCAM-1)to restenosis in patients with lower extremity vascular disease of type 2 diabetes mellitus(T2DM)after interventional therapy.Methods The clinical materials were retrospectively analyzed in patients with lower extremity vascular disease of T2DM(n=104)undergone successful vascular interventional therapy in Department of Vascular Intervention of Handan Central Hospital of Hebei Province from Jan.2022 to Jan 2023.All patients were divided,according to restenosis occurrence after the intervention,into restenosis group(n=20)and non-restenosis group(n=84).The general materials and levels of NLRP3 and sVCAM-1 after the intervention for 24 h were compared between 2 groups.The influence factors of restenosis were analyzed by using multi-factor Logistic regression model.The predictive value of NLRP3 and sVCAM-1 to restenosis was analyzed after established ROC curve.Results The course of T2DM and length of lower extremity arterial lesions were longer in restenosis group than those in non-restenosis group.The proportions of phase IV of Fontaine staging and complete occlusion of lower extremity arteries,and levels of serum glycated hemoglobin(HbAlc),high sensitivity C-reactive protein(hs-CRP),NLRP3 and sVCAM-1 were higher(P<0.05)in restenosis group.The results of multi-factor Logistic regression analysis showed that complete occlusion of lower extremity arteries,length of lower extremity arterial lesions,HbA1c,NLRP3 and sVCAM-1 were influence factors of restenosis in patients with lower extremity vascular disease of T2DM after the intervention(P<0.05).The results of ROC curve analysis showed that the predictive value of NLRP3 combined with sVCAM-1 in detecting restenosis occurrence was higher,and sensitivity was 95.00%,specificity was 71.43%and AUC was 0.929.Conclusion The higher expressions of serum NLRP3 and sVCAM-1 are risk factors of restenosis,and NLRP3 combined with sVCAM-1 can improve the accuracy in predicting restenosis in patients with lower extremity vascular disease of T2DM after the intervention.
关键词
2型糖尿病/下肢血管病变/介入治疗/NOD样受体蛋白3/可溶性血管细胞黏附分子-1Key words
Type 2 diabetes mellitus/Lower extremity vascular disease/Intervention/NOD-like receptor thermal protein domain associated protein 3/Soluble vascular cell adhesion molecules-1引用本文复制引用
基金项目
河北省邯郸市科学技术研究与发展计划项目(22422083042ZC)
出版年
2024
NETL
NSTL
万方数据