带膜血管内支架对Stanford B型胸主动脉夹层病人血清IFN-γ、IL-1β、NF-κB、VEGF水平、心肺功能、远期预后的影响  

Effects of Covered Vascular Stent on Serum IFN-γ,IL-1β,NF-κB,VEGF Levels,Cardiopulmonary Function,and Long-term Prognosis in Patients with Stanford Type B Thoracic Aortic Dissection

作　　者：张霍 吕向妮 付文 倪迎 俞世强 ZHANG Huo;LYU Xiangni;FU Wen;NI Ying;YU Shiqiang(First Affiliated Hospital of Air Force Military Medical University,Xi′an 710000,Shaanxi,China)

机构地区：[1]空军军医大学第一附属医院,西安710000

出　　处：《中西医结合心脑血管病杂志》2022年第11期2017-2021,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家重点研发计划项目(No.2016YFC1301900)。

摘　　要：目的探讨带膜血管内支架对Stanford B型胸主动脉夹层(AD)病人血清干扰素-γ(IFN-γ)、白细胞介素-1β(IL-1β)、核转录因子κB(NF-κB)、血管内皮生长因子(VEGF)水平、心肺功能、远期预后的影响。方法选取2017年1月—2018年6月空军军医大学第一附属医院Stanford B型胸主动脉夹层病人106例,依据随机数字表法分为研究组与对照组,每组53例。对照组采取保守治疗,研究组在对照组基础上采取带膜血管内支架治疗。统计两组治疗前后血清指标(IFN-γ、IL-1β、VEGF、NF-κB)水平、肺功能指标[肺泡动脉氧分压差(PA-aO_(2))、氧合指数(OI)、心功能指标[左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、每搏心输出量(SV)]及假腔与真腔最大直径、并发症发生率、随访2年病死率。结果治疗后,两组血清IFN-γ、IL-1β、VEGF、NF-κB水平较治疗前降低,且研究组低于对照组(P<0.05);治疗后,两组LVEF、SV较治疗前增高,LVEDD、LVESD较治疗前降低,且研究组LVEF、SV高于对照组,LVEDD、LVESD低于对照组(P<0.05);治疗后,两组PA-aO_(2)、OI较治疗前降低,且研究组低于对照组(P<0.05);治疗后,两组真腔最大直径较治疗前增大,假腔最大直径较治疗前缩小,且治疗后,研究组假腔最大直径小于对照组(P<0.05);治疗后,研究组并发症发生率低于对照组(P<0.05),随访2年研究组病死率低于对照组(P<0.05)。结论应用带膜血管内支架治疗Stanford B型胸主动脉夹层可改善病人心肺功能,缩小假腔与真腔最大直径,下调IFN-γ、IL-1β、NF-κB、VEGF等水平,且可降低并发症发生率及疾病病死率。Objective To investigate the effects of covered vascular stent on serum IFN-γ,IL-1β,NF-κB,VEGF levels,cardiopulmonary function,and long-term prognosis of Stanford type B thoracic aortic dissection(AD)patients.Methods A total of 106 patients with Stanford type B thoracic AD were selected and divided into study group and control group according to random number table method,with 53 patients in each group.The control group was treated conservatively,and the study group was treated with covered vascular stent on the basis of the control group.Serum levels of interferon-γ(IFN-γ),interleukin-1β(IL-1β),vascular endothelial growth factor(VEGF),and nuclear factor-κB(NF-κB);pulmonary function indicators of alveolar arterial oxygen partial pressure difference(PA-aO_(2)),oxygenation index(OI),and cardiac function indicators of left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESD),and stroke volume(SV)were measured before and after treatment.The maximum diameter of false cavity and true cavity.The incidence of complications before and after treatment were recorded and potients were followed up for 2 years.Results After treatment,the levels of serum IFN-γ,IL-1β,VEGF,and NF-κB in the two groups were decreased compared with before treatment,and the levels of that in study group were lower than those in control group(P<0.05).After treatment,LVEF and SV in two groups were higher than before treatment,LVEDD and LVESD were lower than that before treatment,and LVEF and SV in study group were higher than that of the control group,while LVEDD and LVESD were lower than that of the control group(P<0.05).After treatment,PA-aO_(2) and OI in both groups were lower than that before treatment,and the study group was lower than that of the control group(P<0.05).After treatment,the maximum diameter of true cavity was increased and the maximum diameter of false cavity was decreased,and the maximum diameter of false cavity in the study group was smaller th

关 键 词：Stanford B型胸主动脉夹层 带膜血管内支架 核转录因子-κB 血管内皮生长因子 心肺功能 远期预后 

分 类 号：R54[医药卫生—心血管疾病]