下肢动脉硬化闭塞症患者金属裸支架置入术后血清miR-647水平与支架内再狭窄相关性研究  

Correlation between Serum Mir-647 Levels and In-Stent Restenosis after Bare Metal Stent Placement in Patients with Lower Limb Atherosclerotic Occlusive Disease

作　　者：张超 张小晶 杨小军[1] 梁萧 林友杰 ZHANG Chao;ZHANG Xiaojing;YANG Xiaojun(Linfen People's Hospital,Shanxi Linfen 041099,China)

机构地区：[1]山西省临汾市人民医院,山西临汾041099 [2]山西医科大学第二医院血管外科,山西太原030001

出　　处：《河北医学》2024年第9期1534-1539,共6页Hebei Medicine

基　　金：山西省医学科技创新团队建设项目,(编号:2020TD21)。

摘　　要：目的:探析下肢动脉硬化闭塞症(ASO)患者金属裸支架置入术后血清短链非编码RNA-647(miR-647)水平变化与支架内再狭窄(ISR)的关联性。方法:纳入182例2020年9月至2023年9月本院收治的下肢ASO患者,检测金属裸支架置入术后血清miR-647水平,分析其水平变化与支架内再狭窄的关联性。结果:182例ASO患者金属裸支架置入术后有43例发生ISR,发生率为23.63%,ISR患者miR-647、中性粒细胞与淋巴细胞比值(NLR)、C反应蛋白(CRP)水平明显高于非ISR患者,差异有统计学意义(P<0.05)。单因素分析显示:ASO患者术后发生ISR与非ISR者在Fontaine分期、年龄及合并高血压、糖尿病方面比较,差异有统计学意义(P<0.05)。Person相关性分析显示:miR-647与中性粒细胞与淋巴细胞比值、C反应蛋白水平呈正相关(r=0.351、0.402,P<0.05)。Logistic回归分析显示:Fontaine分期、年龄、miR-647、NLR、CRP水平和合并高血压、糖尿病是ASO患者术后发生ISR的危险因素,关联有统计学意义(P<0.05)。ROC曲线显示:miR-647表达水平评估术后发生ISR的曲线下面积(AUC)为0.767(95%CI:0.676~0.858),最佳截断值0.980,敏感度0.581,特异度0.899。结论:ASO患者金属裸支架置入术后血清miR-647表达水平与发生ISR有关,且对发生ISR具有一定的预测评估价值。Objective:To explore and analyze the association between serum short non-coding RNA-647(miR-647)level and in-stent restenosis(ISR)in patients with lower extremity arteriosclerosis obliterans(ASO)after bare metal stent implantation.Methods:Totally 182 patients with lower extremity ASO in the hospital were enrolled from September 2020 to September 2023.Serum miR-647 level after bare metal stent implantation was detected,and the correlation between its level change and ISR was analyzed.Results:Out of 182 ASO patients,43 experienced ISR after metal bare stent implantation,with an incidence rate of 23.63%.The levels of miR-647,neutrophil to lymphocyte ratio(NLR),and C-reactive protein(CRP)in ISR patients were significantly higher than those in non-ISR patients,with statistical significance(P<0.05).Univariate analysis showed statistical differences in Fontaine staging,age,hypertension,and diabetes mellitus between ASO patients with postoperative ISR and patients without ISR(P<0.05).Person correlation analysis showed that miR-647 was positively correlated with NLR and CRP levels(r=0.351,0.402,P<0.05).Logistic regression analysis showed that Fontaine staging,age,miR-647,NLR,CRP level,hypertension,and diabetes mellitus were risk factors for postoperative ISR in ASO patients(P<0.05).Concerning the ROC curve,the area under the curve(AUC),optimal cut-off value,sensitivity,and specificity of miR-647 expression level in evaluating postoperative ISR were 0.767(95%CI:0.676-0.858),0.980,0.581 and 0.899 respectively.Conclusion:Serum miR-647 expression in patients with ASO after bare metal stent implantation is related to the occurrence of ISR,and has certain predictive and evaluated value on the occurrence of ISR.

关 键 词：动脉硬化闭塞症 短链非编码RNA-647 支架置入术 支架内再狭窄 

分 类 号：R654.4[医药卫生—外科学]