血管腔内介入治疗糖尿病足合并下肢动脉硬化闭塞症患者术后再狭窄与血清炎症因子的相关性  

Correlation between postoperative restenosis and serum inflammatory factors in patients with diabetic foot complicated with lower extremity atheroscle-rotic occlusive disease treated with intravascular intervention

作　　者：孙艺玮 陈炜[1] 秦巍[1] 杜景辰[1] 孟昕[1] 周永军 Sun Yiwei;Chen Wei;Qin Wei;Du Jingchen;Meng Xin;Zhou Yongjun(Department of Peripheral Vascular Surgery,Heilongjiang Provincial Hospital Xiangfang District,Harbin 150036,China;Department of Surgery,Lanxi People′s Hospital,Suihua 151500,China)

机构地区：[1]黑龙江省医院香坊院区周围血管外科,哈尔滨150036 [2]兰西县人民医院外科,绥化151500

出　　处：《中华损伤与修复杂志（电子版）》2024年第1期34-40,共7页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的探讨血管腔内介入治疗糖尿病足(DF)合并下肢动脉硬化闭塞症(LEASO)患者术后再狭窄与血清炎症因子的相关性。方法选取2020年1月至2022年12月黑龙江省医院香坊院区周围血管外科复诊的50例糖尿病足合并LEASO患者作为研究对象,开展回顾性分析。根据患者是否发生再狭窄,分为未狭窄组(21例)和再狭窄组(29例)。收集两组患者的性别、年龄、糖尿病史、体质量指数(BMI)、空腹血糖(FBG)、收缩压(SBP)、舒张压(DBP)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等临床资料进行分析。分析两组高敏感度C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、基质金属蛋白酶-9(MMP9)、内皮素-1(ET1)、高迁移率族蛋白B1(HMGB1)与再狭窄的相关性。结果再狭窄组患者HbA1c、血管狭窄率、hs-CRP、IL-6、MMP9、ET1、HMGB1均高于未狭窄组,差异具有统计学意义(P<0.05)。血管狭窄率与hs-CRP(r=0.423,P=0.002)、IL-6(r=0.337,P=0.017)、MMP9(r=0.543,P<0.001)、ET1(r=0.670,P<0.001)、HMGB1(r=0.71,P<0.001)、HbA1c(r=0.516,P<0.001)均为正相关关系,影响血管狭窄率的因素有ET1、HMGB1。各类因子AUC大小顺序为HMGB1>ET1>MMP9>HbA1c=hs-CRP>IL-6(Z=5.000,P=0.416)。结论DF合并LEASO患者血管再狭窄的发生与hs-CRP、IL-6、MMP9等炎症因子升高呈正相关。Objective To study the relationship between restenosis and serum inflammatory factors in patients with diabetic foot(DF)complicated with arteriosclerosis obliterans after endovascular intervention.Methods 50 patients with DF complicated with lower extremity arteriosclerosis obliterans(LEASO)who comed for a follow-up visit in Department of Peripheral Vascular Surgery,Heilongjiang Provincial Hospital Xiangfang District from January 2020 to December 2022 were enrolled,and a retrospective analysis was carried out.According to whether the patients had restenosis,they were divided into unstenosis(n=21)and restenosis(n=29).Gender,age,diabetes history,body mass index(BMI),fasting blood glucose(FBG),systolic blood pressure(SBP),diastolic blood pressure(DBP),glycosylated hemoglobin(HbA1c),total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)were collected.Analyzed relationship between the levels of high sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),matrix metalloproteinase-9(MMP9),endothelin-1(ET1),and high mobility group box 1(HMGB1)and restenosis in two groups.Results HbA1c,vascular stenosis rate,hs-CRP,IL-6,MMP9,ET1 and HMGB1 in restenosis group were higher than those in non-stenosis group,and the differences were significant(P<0.05).The vascular stenosis rate was correlated with hs-CRP(r=0.423,P=0.002),IL-6(r=0.337,P=0.017),MMP9(r=0.543,P<0.001),ET1(r=0.670,P<0.001),HMGB1(r=0.71,P<0.001),HbA1c(r=0.516,P<0.001).The factors affecting the rate of vascular stenosis were ET1 and HMGB1.The order of AUC size was HMGB1>ET1>MMP9>HbA1c=hs-CRP>IL-6(Z=5.000,P=0.416).Conclusion Vascular restenosis in DF patients with LEASO is positively correlated with hs-CRP,IL-6,MMP9 and other inflammatory factors.

关 键 词：糖尿病足 闭塞性动脉硬化 下肢 术后再狭窄 血清炎症因子 

分 类 号：R587.2[医药卫生—内分泌]