首页|糖尿病下肢动脉病变介入术后再狭窄与内皮功能的关系研究

糖尿病下肢动脉病变介入术后再狭窄与内皮功能的关系研究

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目的 探讨糖尿病下肢动脉病变(lower extremity arterial disease,LEAD)患者介入治疗术后再狭窄与血管内皮功能的关系.方法 回顾性分析在笔者医院接受介入治疗成功的 133 例LEAD患者,对患者进行持续 1 年的跟踪随访,根据是否发生再狭窄情况进行分组,即分为再狭窄组 25 例与未狭窄组 108 例.检测记录患者血管内皮功能指标、炎性因子水平、血脂 4 项以及糖化血红蛋白(hemoglobin A1c,HbAlc),并分离狭窄组和未狭窄组患者外周血裂红后细胞进行转录组测序.采用多因素非条件 Logistic 回归分析筛选术后再狭窄的血管内皮功能独立风险因子.结果 狭窄组的血清内皮素(endothelin-1,ET-1)、血管性假性血友病因子(von willebrand factor,vWF)、血栓素 B2(thromboxane B2,TXB2)、血管细胞黏附分子 1(vascular cell adhesion protein 1,VCAM-1)及一氧化氮(nitric oxide,NO)均显著高于未狭窄组,而内皮一氧化氮合酶(endothelial nitric oxide synthase,eNOS)和血管内皮生长因子(vascular endothelial growth factor,VEGF)均显著低于未狭窄组(P<0.01).两组患者的血脂 4 项差异无统计学意义(P>0.05);且狭窄组的HbAlc显著高于未狭窄组(P<0.01).狭窄组炎症因子表达水平显著高于未狭窄组(P<0.05).转录组测序分析结果与检测结果一致.多因素Logistic回归分析发现,肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素(interleukin,IL)-6、ET-1、vWF 均是导致 LEAD 血管再狭窄的独立危险因素(P<0.05).结论 血管内皮功能指标(ET-1、vWF)与炎性因子(TNF-α、IL-6)为LEAD患者介入术后再狭窄的独立危险因素.
Study on the relationship between restenosis and endothelial function after interventional surgery for diabetic lower extremity arteriopathy
Objective To explore the relationship between postoperative restenosis and vascular endothelial function in patients with lower extremity arterial disease(LEAD).Methods A retrospective analysis was performed on 133 patients with diabetic lower extremity arteriopathy who had successfully undergone interventional therapy in our hospital,and the patients were followed up for one year,and the patients were grouped according to whether restenosis occurred,with 25 cases in the restenosis group and 108 cases in the non-stenosis group.The patient's vascular endothelial function index,inflammatory factor level,blood lipid four items and hemoglobin A1c(HbAlc)were detected,and peripheral blood cells of patients in the stenosis group and non-stenosis group were isolated for transcriptome sequencing.Multivariate unconditional logistic regression analysis was used to screen for independent risk factors for vascular endothelial function in postoperative restenosis.Results Serum endothelin-1(ET-1),von Willebrand factor(vWF),thromboxane B2(TXB2),vascular cell adhesion protein 1(VCAM-1),and nitric oxide(NO)were significantly higher in the stenosis group than in the non-stenosis group,while endothelial nitric oxide synthase(eNOS)and vascular endothelial growth factor(VEGF)were significantly lower than those in the non-stenosis group(P<0.01).There was no significant difference in blood lipids between the two groups(P>0.05).The HbAlc of the stenosis group was significantly higher than that of the non-stenosis group(P<0.01).The inflammatory factors in the stenosis group were significantly higher than those in the non-stenosis group(P<0.05).Transcriptome sequencing analysis results are consistent with test results.Multivariate Logistic regression analysis showed that TNF-α,IL-6,ET-1,and vWF were independent risk factors for LEAD vascular restenosis(P<0.05).Conclusion Vascular endothelial function indexes(ET-1,vWF)and inflammatory factors(TNF-α,IL-6)are independent risk factors for restenosis after interventional surgery.

Diabetic lower extremity arteriopathyInterventional therapyVascular restenosisVascular endothelial function

唐建红、陈明高、白文斌

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金华市人民医院介入与血管外科,浙江金华 321000

糖尿病下肢动脉病变 介入治疗 血管再狭窄 血管内皮功能

浙江省金华市公益性技术应用研究项目(2022)

2022-4-162

2024

中国现代医生
中国医学科学院

中国现代医生

影响因子:1.571
ISSN:1673-9701
年,卷(期):2024.62(11)
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