血清IL-8、VEGF水平与下肢动脉硬化闭塞症患者支架植入术后1年内支架内再狭窄的关系  

Association of serum IL-8 and VEGF levels with in-stent restenosis in lower limb arteriosclerosis obliterans patients within 1 year after stent implantation

作　　者：胡威龙 王高尚 张小兵 张同庆 HU Weilong;WANG Gaoshang;ZHANG Xiaobing;ZHANG Tongqing(Department of Vascular Surgery,Nanyang First People's Hospital,Nanyang,Henan 473000,China)

机构地区：[1]河南省南阳市第一人民医院血管外科,河南南阳473000

出　　处：《中国普通外科杂志》2024年第6期943-951,共9页China Journal of General Surgery

摘　　要：背景与目的:支架植入术是治疗下肢动脉硬化闭塞症(ASO)的主要治疗方式之一,可有效恢复血管畅通,改善患者临床症状,但部分患者术后1年内易出现支架内再狭窄。支架内再狭窄可导致患者较差的预后,因此明确影响ASO术后支架再狭窄的病理机制具有重要意义。血清白细胞介素8(IL-8)与血管内皮生长因子(VEGF)分别是反映机体炎症和血管内皮功能的指标,与ASO的发生关系密切,但是否与ASO患者支架植入术后支架再狭窄相关尚不明确。鉴于此,本研究对IL-8、VEGF水平与ASO患者支架植入术后1年内支架内再狭窄的关系进行探讨,并建立预测支架植入术后1年内支架内再狭窄的列线图模型。方法:选取2020年1月—2022年10月河南省南阳市第一人民医院血管外科接受支架植入手术治疗的100例ASO患者为研究对象,术后随访1年,根据随访结果将受试者分为再狭窄组和未再狭窄组。收集受试者人口学特征、术后血清IL-8与VEGF水平及其他相关指标等。采用单因素和Logistic回归分析影响支架植入术后1年内支架内再狭窄的危险因素。基于危险因素构建预测支架植入术后1年支架内再狭窄的风险列线图预测模型,并对构建的预测模型进行验证。结果:随访期间失访4例,失访率为4.00%(4/100)。96例患者中29例患者发生支架内再狭窄,支架内再狭窄率为30.21%(29/96)。Logistic回归分析结果显示,年龄≥60岁(OR=4.191)、Fontaine分期(Ⅳ期)(OR=2.863)、完全闭塞(OR=2.445)、下肢血管病变长度≥7.15 cm(OR=3.343)、术后IL-8≥1.02 ng/mL(OR=6.482)、术后VEGF≥158.37 pg/mL(OR=10.402)是影响支架植入术后1年支架内再狭窄的独立危险因素(均P<0.05)。对基于以上因素构建的列线图预测模型的验证结果显示,校正曲线贴近于理想曲线;C指数为0.857(95%CI=0.785~0.952);受试者工作特征(ROC)曲线结果显示,列线图风险模型预测支架植入术后1年支架内再�Background and Aims:Stent implantation is one of the main treatments for lower extremity arteriosclerosis obliterans(ASO).It effectively restores vascular patency and improves clinical symptoms,but some patients experience in-stent restenosis within one year after surgery.In-stent restenosis can lead to poor prognosis for patients,making it crucial to understand the pathological mechanisms influencing restenosis after surgery for ASO.Serum interleukin 8(IL-8)and vascular endothelial growth factor(VEGF)are indicators of inflammation and endothelial function,respectively,and are closely related to the occurrence of ASO.However,it is unclear whether they are associated with in-stent restenosis after stent implantation for ASO.Therefore,this study was conducted to investigate the association of IL-8 and VEGF levels with in-stent restenosis in ASO patients within one year after stent implantation,and establish a nomogram model to predict in-stent restenosis within after stent implantation.Methods:A total of 100 ASO patients who received stent implantation at Department of Vascular Surgery,Nanyang First People's Hospital between January 2020 and October 2022 were selected for the study.Patients were followed up for one year after-surgery and divided into restenosis and non-restenosis groups based on follow-up results.Demographic characteristics,postoperative serum IL-8 and VEGF levels,and other relevant variables were collected.Univariate and Logistic regression analyses were used to identify risk factors for in-stent restenosis within one year after stent implantation.A nomogram model was constructed based on these risk factors to predict the risk of in-stent restenosis within one year after stent implantation,and the predictive model was validated.Results:Four patients were lost to follow-up,resulting in a loss rate of 4.00%(4/100).Among the 96 patients,29 experienced in-stent restenosis,with an in-stent restenosis rate of 30.21%(29/96).Logistic regression analysis revealed that age≥60 years(OR=4.191),Fontaine stag

关 键 词：闭塞性动脉硬化 下肢 移植物闭塞 血管 白细胞介素8 血管内皮生长因子类 

分 类 号：R654.3[医药卫生—外科学]