主动脉夹层腔内修复术后血浆TC、CRP、VEGF变化与假腔血栓化程度的相关性及临床意义  

Correlation between the changes of TC,CRP,VEGF after thoracic endovascular aortic repair and the degree of false lumen thrombosis and its clinical significance

作　　者：马冬纹[1] 张蕊[2] 蔡国强[1] 赵永亮[3] Ma Dongwen;Zhang Rui;Cai Guoqiang;Zhao Yongliang(Department of Cardiology,Affiliated Hospital of Jining Medical University,Jining 272100,China;Department of Cardiac Rehabilitation Prevention Clinic,Affiliated Hospital of Jining Medical University,Jining 272100,China;Department of Cardiac Surgery,Affiliated Hospital of Jining Medical University,Jining 272100,China)

机构地区：[1]济宁医学院附属医院心脏重症医学科,济宁272100 [2]济宁医学院附属医院心脏康复预防门诊,济宁272100 [3]济宁医学院附属医院心脏外科,济宁272100

出　　处：《中国医师杂志》2022年第9期1373-1378,共6页Journal of Chinese Physician

摘　　要：目的探讨主动脉夹层腔内修复术(TEVAR)后血浆总胆固醇(TC)、C反应蛋白(CRP)、血管内皮生长因子(VEGF)变化与假腔血栓化程度的关系及临床意义。方法选取2015年6月至2020年7月济宁医学院附属医院收治的95例主动脉夹层患者进行回顾性研究,均行腔内修复术治疗。根据术后6个月CT血管造影检查假腔消失情况分为完全消失组(n=43)、未完全消失组(n=52),比较两组术前、术后1、3个月血浆TC、CRP、VEGF水平,并比较两组术后1、3个月假腔血栓化程度,应用Spearman法分析各指标与术后假腔血栓化程度的相关性,多因素logistic回归分析TEVAR术后假腔消失的影响因素;采用受试者工作特征(ROC)曲线及曲线下面积(AUC)分析各指标预测假腔完全消失的价值。结果完全消失组术后1、3个月的血浆TC、CRP、VEGF水平均低于未完全消失组(均P<0.05);完全消失组术后1、3个月的假腔血栓化程度与未完全消失组比较,差异有统计学意义(均P<0.05);TEVAR术后1、3个月的血浆TC、CRP、VEGF水平与假腔血栓化程度呈负相关(均P<0.05);多因素logistic回归分析显示,术后1、3个月血浆TC、CRP、VEGF水平均与假腔消失相关(均P<0.05);随着时间推移,各指标预测假腔完全消失的AUC逐渐增大,至术后3个月,TC、CRP、VEGF及联合预测假腔完全消失的AUC分别为0.706、0.899、0.781、0.943(均P<0.05)。结论TEVAR术后血浆TC、CRP、VEGF水平变化与主动脉夹层患者假腔血栓化程度和假腔消失情况有关,三者联合检查可有效预测假腔完全消失。Objective To explore the relationship between the changes of total cholesterol(TC),C-reactive protein(CRP),vascular endothelial growth factor(VEGF)and the degree of false lumen thrombosis after thoracic endovascular aortic repair(TEVAR)and its clinical significance.Methods A total of 95 patients with aortic dissection admitted to the Affiliated Hospital of Jining Medical College from June 2015 to July 2020 were selected for retrospective study.All patients were treated with TEVAR.According to the disappearance of false lumen detected by computed tomography(CT)angiography six months after operation,95 patients were divided into complete disappearance group(n=43)and incomplete disappearance group(n=52).The levels of plasma TC,CRP and VEGF in the two groups were compared before operation and 1 and 3 months after operation,as well as the degree of false lumen thrombosis.Spearman′s method was used to analyze the relationship between the levels of plasma TC,CRP and VEGF and the degree of postoperative false lumen thrombosis;multivariate logistic regression was used to analyze the factors affecting the disappearance of false lumen after TEVAR;The receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to analyze the value of each index in predicting the complete disappearance of false lumen.Results The plasma levels of TC,CRP and VEGF in the complete disappearance group were lower than those in the incomplete disappearance group 1 and 3 months after operation(all P<0.05).The degree of false lumen thrombosis in the complete disappearance group was significantly different from that in the incomplete disappearance group 1 and 3 months after operation(all P<0.05).The plasma levels of TC,CRP and VEGF 1 and 3 months after TEVAR were negatively correlated with the degree of false lumen thrombosis(all P<0.05).Multivariate logistic regression analysis showed that the plasma levels of TC,CRP and VEGF 1 and 3 months after operation were correlated with the disappearance of false lumen(all P<0.05).With

关 键 词：动脉瘤 夹层 主动脉瘤 腔内修复术 胆固醇 C反应蛋白质 血管内皮生长因子 

分 类 号：R654.3[医药卫生—外科学]