并发于T2DM的膝下动脉硬化闭塞症患者PTA术前血清GDF-15水平与术后病变血管再狭窄关系  

Correlation between preoperative serum growth differentiation factor 15 and postoperative vascular restenosis in T2DM patients with below-knee arteriosclerosis obliterans

作　　者：王晓宇 冯等等 张亚琴 赵晓彤[1] 罗莉[1] 陈智勇[1] 张君[1] 陈明卫[1,2] WANG Xiaoyu;FENG Dengdeng;ZHANG Yaqin;ZHAO Xiaotong;LUO Li;CHEN Zhiyong;ZHANG Jun;CHEN Mingwei(The First Affiliated Hospital of Anhui Medical University,Hefei 230032,China)

机构地区：[1]安徽医科大学第一附属医院,合肥230032 [2]安徽省中医药科学院中医药糖尿病防治研究所

出　　处：《山东医药》2019年第33期31-34,共4页Shandong Medical Journal

基　　金：中华医学会临床科研专项基金资助项目(17051250670);安徽省卫生厅医学科研重点项目(2010A008)

摘　　要：目的探讨并发于2型糖尿病(T2DM)的膝下动脉硬化闭塞症(ASO)患者经皮球囊扩张成形术(PTA)治疗前血清生长分化因子15(GDF-15)水平与术后病变血管再狭窄的关系。方法并发于T2DM的膝下ASO患者102例,均成功接受PTA术治疗,PTA术前检测血清GDF-15,根据术后6个月内是否出现球囊扩张部位血管再狭窄分为再狭窄组和非再狭窄组,比较两组血清GDF-15水平;根据术前血清GDF-15中位数水平,将102例并发于T2DM的膝下ASO患者分为高、低GDF-15组,比较两组术后病变血管再狭窄发生率。分析血清GDF-15水平与并发于T2DM的膝下ASO患者PTA术后病变血管再狭窄及血糖、血脂、炎性指标的关系。结果与非再狭窄组相比,再狭窄组患者术前GDF-15水平高(P<0.05)。与低GDF-15组相比,高GDF-15组患者PTA术后病变血管再狭窄的发生率升高(P<0.05)。血清GDF-15及HbA 1c、LDL-C、hs-CRP水平升高均是并发于T2DM的膝下ASO患者PTA术后病变血管再狭窄的独立危险因素(P均<0.05),血清GDF-15水平与HbA 1c、LDL-C、hs-CRP水平呈正相关(P均<0.05)。结论并发于T2DM的膝下ASO患者PTA术治疗前血清GDF-15水平与术后病变血管再狭窄有关,高血清GDF-15水平是PTA术后病变血管再狭窄的危险因素。Objective To investigate the correlation between preoperative serum growth differentiation factor 15(GDF-15)and postoperative vascular restenosis in type 2 diabetes(T2DM)patients with below-knee arteriosclerosis obliterans(ASO).Methods Totally 102 T2DM patients with below-knee ASO received percutaneous transluminal angiography(PTA),and the serum GDF-15 was detected before PTA.Patients were divided into the restenosis group(n=34)and non-restenosis group(n=68)by the presence of vascular restenosis at the site of balloon dilation within 6 months after surgery.The serum GDF-15 levels were compared between these two groups.According to the median level of GDF-15 before surgery,102 T2DM patients with below-knee ASO were divided into the high GDF-15 group and low GDF-15 group.We compared the incidence of postoperative vascular restenosis between the two groups.The relationships of serum GDF-15 level with the postoperative vascular restenosis,blood glucose,blood lipid,and inflammatory indicators in T2DM patients with below-knee ASO were analyzed.Results Compared with the non-stenosis group,the serum GDF-15 in the restenosis group increased(P<0.05);compared with the low GDF-15 group,the incidence of postoperative vascular restenosis in the high GDF-15 group increased(P<0.05).Compared with the non-stenosis group,the levels of HbA1c,low-density lipoprotein cholesterol(LDL-C),and hs-CRP in the restenosis group increased(all P<0.05);the serum GDF-15 was positively correlated with HbA1c,LDL-C and hs-CRP(all P<0.05);the increased HbA1c,LDL-C,hs-CRP,and GDF-15 levels were independent risk factors for postoperative vascular restenosis in T2DM patients with below-knee ASO(all P<0.05).Conclusion Serum GDF-15 level of T2DM patients with below-knee ASO before PTA is related to postoperative vascular restenosis,and the high GDF-15 level is a risk factor for vascular restenosis after PTA.

关 键 词：生长分化因子 生长分化因子15 病变血管再狭窄 经皮球囊扩张成形术并发症 动脉硬化闭塞症 糖尿病并发症 

分 类 号：R73.5[医药卫生—肿瘤]