紫杉醇药涂球囊扩张治疗ASO患者疗效及SIRT7水平对术后血管再狭窄的预测  

Efficacy of paclitaxel drug-coated balloon in patients with ASO and prediction of SIRT7 level on postoperative vascular restenosis

作　　者：俞慎林[1] 施森 张济[1] 李光泽[1] 林昌俭 YU Shenlin;SHI Sen;ZHANG Ji;LI Guangze;LIN Changjian(Department of Vascular and Pediatric Surgery,Leshan People's Hospital,Leshan 614099,Sichuan,China;Department of Vascular Surgery,Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan,China)

机构地区：[1]乐山市人民医院血管小儿外科,四川省乐山市614099 [2]西南医科大学附属医院血管外科,四川省泸州市646000

出　　处：《中南医学科学杂志》2022年第6期849-852,共4页Medical Science Journal of Central South China

基　　金：国家自然科学基金项目(81500643)。

摘　　要：目的观察紫杉醇药涂球囊扩张(DCB)治疗下肢动脉硬化闭塞症(ASO)疗效及SIRT7水平对术后血管再狭窄的预测。方法将112例下肢ASO患者随机均分为DCB组和金属裸支架(BMS)组。比较两组患者临床疗效、血管畅通率、靶病变血流重建率、动脉硬化指标、血流动力学指标、血小板活化因子水平及沉默信息调节因子7(SIRT7)水平。根据术后血管是否发生再狭窄分为狭窄组和对照组,Logistic回归分析其术后血管再狭窄的高危因素,ROC曲线下面积评价SIRT7对其术后再狭窄的预测效能。结果与BMS组比较,DCB组临床疗效、术后血管畅通率、血小板活化因子水平升高,靶病变血流重建率、动脉硬化指标、血流动力学指标水平降低(P<0.05)。狭窄组术后SIRT7水平较对照组降低(P<0.05)。术后低SIRT7水平是其术后再狭窄的高危因素,对其术后血管再狭窄的预测效能较高。结论DCB治疗ASO的疗效满意;术后低SIRT7水平为支架术后血管再狭窄的有效预测指标。Aim To observe the efficacy of paclitaxel drug-coated balloon dilation(DCB)in the treatment of low extremity arteriosclerosis obliterans(ASO)and the prediction of SIRT7 level postoperative vascular restenosis.Methods 112 patients with low extremity ASO were randomly divided into DCB group and bare metal stent(BMS)group.The clinical efficacy,vascular patency rate,target lesion blood flow reconstruction rate,arteriosclerosis index,hemodynamic index,platelet activating factor level and silent information regulating factor 7(SIRT7)levels were compared between the two groups.The patients were divided into stenosis group and control group according to whether postoperative vascular restenosis occurred or not.Multivariate logistic regression was used to analyze the high risk factors of postoperative restenosis,and the area under ROC was used to evaluate the predictive efficacy of SIRT7 on postoperative restenosis.Results Compared with BMS group,the clinical efficacy,postoperative vascular patency rate,platelet activating factor level in DCB group were significantly increased,target lesion blood flow reconstruction rate,arteriosclerosis index,improvement of hemodynamic index in DCB group decreased(P<0.05).The postoperative SIRT7 level in the stenosis group was lower than that in the control group(P<0.05).Low postoperative SIRT7 level is a high risk factor for postoperative restenosis,and has a high predictive effect on postoperative restenosis.Conclusion DCB has a satisfactory therapeutic effect on ASO;Low SIRT7 level is an effective predictor of restenosis after stenting.

关 键 词：紫杉醇药涂球囊扩张成形术 动脉硬化闭塞症 沉默信息调节因子7 术后血管再狭窄 

分 类 号：R543.5[医药卫生—心血管疾病]