经皮氧分压联合血清ox-LDL预测下肢动脉硬化闭塞症介入治疗后再狭窄的临床价值  

Clinical value of transcutaneous oxygen pressure combined with serum ox-LDL in predicting restenosis after interventional therapy for lower arteriosclerosis obliterans

作　　者：王倩竹 朱美冬 宋福晨 葛玮婧 张磊[1] WANG Qianzhu;ZHU Meidong;SONG Fuchen;GE Weijing;ZHANG Lei(Department of Vascular Surgery,Yueyang Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200443,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院血管外科,上海市200443

出　　处：《中国动脉硬化杂志》2023年第5期427-431,共5页Chinese Journal of Arteriosclerosis

基　　金：上海申康医院发展中心临床科技创新项目(SHDC12019X33);国家科技部“中医药现代化研究”重点专项(2019YFC1711604)。

摘　　要：[目的]探究经皮氧分压(TcPO_(2))联合血清氧化型低密度脂蛋白(ox-LDL)预测下肢动脉硬化闭塞症(LASO)介入治疗后再狭窄的临床价值。[方法]选取2020年1月—2021年6月在上海中医药大学附属岳阳中西医结合医院行介入治疗的113例LASO患者为观察对象,根据介入治疗后1年再狭窄发生情况将其分为未狭窄组(n=79)和再狭窄组(n=34),采用ELISA及相应试剂盒检测血清ox-LDL水平,运用激光多普勒血流仪测量T cPO_(2),比较两组资料及TcPO_(2)、ox-LDL值,多因素Logistic回归模型研究LASO介入治疗后再狭窄的影响因素,采用Spearman检验进行相关性分析,ROC曲线评估TcPO_(2)、ox-LDL值预测LASO介入治疗后再狭窄的效能。[结果]两组年龄、体质指数(BMI)、性别、饮酒、脑血管疾病史、冠心病史、病变血管支数、空腹血糖、同型半胱氨酸水平比较差异无统计学意义(P>0.05)。与未狭窄组比较,再狭窄组吸烟、术后不规律用药、植入支架数量、ox-LDL和血尿酸水平明显增高(P<0.05),TcPO_(2)明显降低(P<0.05)。Logistic回归模型分析显示,吸烟、术后不规律用药、植入支架数量多、TcPO_(2)降低、ox-LDL和血尿酸增高为LASO介入治疗后再狭窄的危险因素(P<0.05)。Spearman检验显示,ox-LDL与LASO介入治疗后再狭窄呈正相关(r=0.513,P<0.001),TcPO_(2)与其呈负相关(r=-0.524,P<0.001)。ROC曲线分析显示,TcPO_(2)+ox-LDL预测LASO介入治疗后再狭窄时的效能(AUC=0.802)高于各指标单独应用时,其预测的灵敏度和特异度为67.60%、94.90%,临界点为37.23 mmHg、5.31 mmol/L。[结论]LASO介入治疗后再狭窄患者TcPO_(2)降低、ox-LDL增高,二者对LASO介入治疗后再狭窄有一定预测价值,TcPO_(2)与ox-LDL结合能更全面反映介入治疗后再狭窄情况。Aim To explore the clinical value of transcutaneous oxygen pressure(TcPO_(2))combined with serum oxidized low density lipoprotein(ox-LDL)in predicting restenosis after interventional therapy for lower arteriosclerosis obliterans(LASO).Methods 113 patients with LASO underwent interventional therapy in Yueyang Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2020 to June 2021 were enrolled,and classified into non-stenosis group(n=79)and restenosis group(n=34)according to the occurrence of restenosis 1 year after interventional treatment.Serum ox-LDL levels were detected by ELISA and corresponding assay kits,and TcPO_(2) was measured by laser Doppler flowmeter.Then comparison was conducted on general data,TcPO_(2) and ox-LDL.Multivariate Logistic regression model was used to screen the influencing factors of restenosis after intervention therapy for LASO.Spearman test was used for correlation analysis,ROC curve was used to evaluate the efficacy of TcPO_(2) and ox-LDL in predicting restenosis in LASO patients after intervention therapy.Results There was no significant difference between the two groups in age,body mass index(BMI),sex,alcohol consumption,history of cerebrovascular disease and coronary heart disease,number of diseased vessels,fasting blood glucose,and homocysteine(P>0.05).Compared with the non-stenosis group,smoking,irregular drug use,the number of implanted stents,ox-LDL,and the level of blood uric acid in the restenosis group were significantly higher(P<0.05),and TcPO_(2) was significantly lower(P<0.05).Logistic regression model analysis showed that smoking,irregular drug use after LASO intervention,large number of implanted stents,decreased TcPO_(2),ox-LDL,and increased blood uric acid were the risk factors for restenosis after LASO intervention(P<0.05).Spearman test showed that ox-LDL was positively correlated with restenosis after LASO intervention(r=0.513,P<0.001),and TcPO_(2) was negatively correlated with

关 键 词：经皮氧分压 氧化型低密度脂蛋白 下肢动脉硬化闭塞症 介入治疗 再狭窄 

分 类 号：R5[医药卫生—内科学]