高敏C反应蛋白、白细胞介素6水平对股腘动脉支架植入术后再狭窄的影响  

Impacts of high-sensitive C-reactive protein and interleukin 6 level on restenosis after femoropopliteal stenting

作　　者：李云松[1] 毕伟[2] 张彦荣[2] 田锦林[1] 王伟[1] 郭跃辉[1] 

机构地区：[1]中国人民解放军第二五二医院介入血管外科,河北保定071000 [2]河北医科大学第二医院血管外科,河北石家庄050000

出　　处：《中国普通外科杂志》2014年第6期755-758,共4页China Journal of General Surgery

摘　　要：目的:探讨围手术期高敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)水平对股腘动脉支架植入术后再狭窄的影响。方法:选择47例行支架植入术治疗的股腘动脉闭塞患者,于术前24 h、术后3 d检测血清hs-CRP、IL-6水平,术后随访6个月,应用超声检查支架内再狭窄情况,分析hs-CRP、IL-6水平及术前血糖、血脂状况、病变程度与术后再狭窄的关系。结果:47例患者均成功实施了股腘动脉支架植入术,术后随访6个月中,13例发生再狭窄。再狭窄组术前24 h与术后3 d的hs-CRP、IL-6水平均明显高于无再狭窄组(均P<0.05);无论是再狭窄组还是无再狭窄组,术后hs-CRP、IL-6水平均较术前升高,但两组间两者的升高程度差异无统计学意义(均P>0.05)。此外,再狭窄组糖尿病患者比例高于无再狭窄组(P<0.05);术前TASC II分级越高,术后再狭窄率越高(χ2=7.245,P=0.027)。结论:围手术期炎症因子hs-CRP、IL-6水平增高,股腘动脉支架植入术后再狭窄的风险增加,此外,再狭窄还与糖尿病及术前股腘动脉病变程度密切相关。Objective： To investigate the influence of perioperative level of high-sensitive C-reactive protein （hs-CRP） and interleukin 6 （IL-6） on restenosis following femoropopliteal stenting.Methods： Forty-seven patients with femoropopliteal arterial occlusive disease undergoing stent implantation were selected, and their serum levels ofhs-CRP and IL-6 on 24 h before and 3 d after operation were determined.Patients were followed-up for 6 months, and ultrasonography was used to detect intra-stent stenosis. The relations of hs-CRP and IL-6 level as well as the preoperative blood glucose concentration, lipid profile and degree ofdisease with postoperative restenosis were analyzed. Results： All the 47 patients were successfully managed with femoropopliteal stenting, and restenosis occurredin 13 cases during the postoperative follow-up period of 6 months. The levels ofhs-CRP and IL-6 at 24 h before and 3 d after operation in restenosis group were all significantly higher than those in non-restenosis group （all P〈0.05 ）,and in both the restenosis group and non-restenosis group, the postoperative hs-CRP and IL-6 levels were increased compared with the levels before operation, but the differences in their increasing degrees between the two groupsshowed no statistical significance （both P〉0.05）. In addition, the ratio of patients with diabetes mellitus in restenosis group was higher than that in non-restenosis group （P〈0.05）, and the higher the preoperative TASC Ⅱ grade was, themore frequent was the occurrence of postoperative restenosis （X^2=7.245, P=0.027）. Conclusion： Increased preoperative levels of hs-CRP and IL-6 may increase the risk of restenosis afterfemoropopliteal stenting, and moreover, restenosis is also closely associated with diabetes mellitus and preoperative severity of the femoropopliteal arterial lesion.

关 键 词：动脉硬化 闭塞性 下肢 支架 移植物闭塞 血管 C反应蛋白质 白细胞介素6 

分 类 号：R654.3[医药卫生—外科学]