颈动脉内膜切除前后颈动脉血管结构特征和血清sICAM-1、MCP-1水平变化及与患者复发风险的关系  

Changes in carotid vascular structural features and serum levels of sICAM-1 and MCP-1 before and after carotid endarterectomy and their relationship with patient risk of recurrence

作　　者：郭兴友 张拓 范卫东 刘坤 李明 付勇猛 GUO Xing-you;ZHANG Tuo;FAN Wei-dong(Department of Vascular Surgery,Suqian First People's Hospital,Suqian Jiangsu 223800,China)

机构地区：[1]宿迁市第一人民医院血管外科,江苏宿迁223800

出　　处：《临床和实验医学杂志》2024年第1期49-53,共5页Journal of Clinical and Experimental Medicine

基　　金：江苏省青年医学重点人才培养项目(编号:QNRC2016480)。

摘　　要：目的探究颈动脉内膜切除前后颈动脉血管结构特征、血清可溶性细胞间黏附分子-1(sICAM-1)、血清单核细胞趋化因子-1(MCP-1)水平变化及与患者复发风险的关系。方法回顾性选取于2017年1月至2022年1月在宿迁市第一人民医院进行颈动脉内膜切除的80例颈动脉重度狭窄患者为研究对象,对患者进行3个月随访,根据患者术后是否发生颈内动脉再狭窄将患者分为复发组(n=8)和未复发组(n=72)。比较组间术前、术后3个月患者的颈动脉血管结构特征变化,记录患者术前、术后1周、术后1~3个月的血清sICAM-1、MCP-1水平。结果两组术前CCA远段管径、CB/CCA远段管径比值、CB/ICA近段管径比值及术后CB管径比较,差异均无统计学意义(P>0.05);复发组术前ICA近段管径、CB管径和术后CCA远段管径、ICA近段管径均低于未复发组,术后CB/CCA远段管径比值、CB/ICA近段管径比值高于未复发组,差异均有统计学意义(P<0.05)。术前及术后1周,两组间的血清sICAM-1、MCP-1水平比较,差异均无统计学意义(P>0.05);术后1、2、3个月,复发组的sICAM-1、MCP-1水平均显著高于未复发组,差异均有统计学意义(P<0.05)。多因素分析可知,术后ICA近段管径、术后CB/CCA远段管径比值、术后2个月血清sICAM-1水平、术后3个月血清sICAM-1水平、术后2个月血清MCP-1水平为患者进行颈动脉内膜切除术后复发的影响因素(P<0.05)。结论颈动脉重度狭窄患者经颈动脉内膜切除术后,应对患者的颈动脉血管结构特征和血清sICAM-1、MCP-1水平变化予以关注,可提早预防患者术后复发,对患者远期疗效具有重要意义。Objective To explore the characteristics of carotid vascular structure,serum soluble cell adhesion molecule-1(sICAM-1),monocyte chemotactic protein-1(MCP-1)before and after carotid endarterectomy and the risk of recurrence.Methods The study subjects included 80 patients with severe carotid artery stenosis treated in Suqian First People's Hospital from January 2017 to January 2022.After three months,the patients were divided into the recurrent group(n=8)and and the non-recurrent group(n=72)according to whether the postoperative internal carotid artery restenosis,comparing the characteristics of carotid vessels before and three months after surgery and record the serum levels of sICAM-1 and 1 to 3 months after surgery.Results There were no statistically significant differences in preoperative CCA distal diameter,CB/CCA distal diameter ratio,CB/ICA proximal diameter ratio,and postoperative CB diameter between the two groups(P>0.05);the preoperative ICA proximal diameter,CB diameter,and postoperative CCA distal diameter and ICA proximal diameter in the recurrent group were lower than those in the non-recurrent group,the postoperative CB/CCA distal diameter ratio and CB/ICA proximal diameter ratio were higher than those of the non-recurrent group,and the differences were statistically significant(P<0.05).There were no statistically significant differences in serum sICAM-1 and MCP-1 levels between the two groups before and one week after surgery(P>0.05);at 1,2,and 3 months after surgery,the levels of sICAM-1 and MCP-1 in the recurrent group were significantly higher than those in the non-recurrent group,and the differences were statistically significant(P<0.05).With the dependent variable,the diameter of ICA,diameter ratio of CB/CCA,2-month serum,serum sICAM-1 level,and MCP-1 level were the factors for recurrence after carotid endarterectomy(P<0.05).Conclusion In patients with severe carotid stenosis after carotid endarterectomy should pay attention to the changes of sICAM-1 and MCP-1 levels,which can prevent postopera

关 键 词：颈动脉内膜切除术 颈动脉血管结构特征 可溶性细胞间黏附分子-1 单核细胞趋化因子-1 复发风险 

分 类 号：R651.12[医药卫生—外科学]