血清sICAM-3、ET-1与sEndoglin水平联合检测在主动脉夹层术后复发风险评估中的价值  

Value of combined detection of serum sICAM-3,ET-1 and sEndoglin levels in the risk assessment of recurrence after aortic dissection

作　　者：刘阳 孙欢欢[1] 袁涛[1] 师龙 郭涛[2] 高翔[1] LIU Yang;SUN Huanhuan;YUAN Tao;SHI Long;GUO Tao;GAO Xiang(Department of Vascular Surgery,the Second Hospital of Hebei Medical University,Shijiazhuang,Hebei,China,050000;Department of Oral and Maxillofacial Surgery,Hebei Chest Hospital,Shijiazhuang,Hebei,China,050000)

机构地区：[1]河北医科大学第二医院血管外科,河北石家庄050000 [2]河北省胸科医院口腔颌面外科,河北石家庄050000

出　　处：《分子诊断与治疗杂志》2024年第10期1974-1977,共4页Journal of Molecular Diagnostics and Therapy

基　　金：河北省医学科学研究课题计划(20230533)。

摘　　要：目的分析血清可溶性细胞间粘附分子-3(sICAM-3)、内皮素1(ET-1)与可溶性内皮抑素(sEndoglin,sEng)水平联合检测在主动脉夹层术后复发风险评估中的价值。方法回顾性纳入自2018年3月至2023年5月于河北医科大学第二医院行Stanford B型主动脉夹层术患者102例,依据随访结果将102例患者分为复发组16例、未复发组86例。比较两组一般资料、sICAM-3、ET-1及sEng水平变化;分析影响主动脉夹层术后复发的危险因素,绘制ROC曲线评估sICAM-3、ET-1及sEng单独及联合检测对主动脉夹层术后复发风险的预测价值。结果复发组、未复发组年龄、性别、吸烟史、饮酒史、糖尿病史、高血压史、马凡综合征占比比较,差异无统计学意义(P>0.05);复发组年龄≥60岁、合并马凡综合征、分支受累数目>6条占比均高于无复发组,差异有统计学意义(P<0.05)。复发组sICAM-3、ET-1与sEng水平均明显高于无复发组,差异有统计学意义(P<0.05)。经logistic多因素分析显示:年龄≥60岁、合并马凡综合征、分支受累数目>6条、sICAM-3、ET-1与sEng水平均上升是影响主动脉夹层术后复发的危险因素(P<0.05)。依据ROC曲线可知,sICAM-3、ET-1与sEng联合预测主动脉夹层术后复发风险的敏感度和特异度分别为89.60%、88.30%,AUC为0.872,高于sICAM-3、ET-1与sEng单独检测(P<0.05)。结论sICAM-3、ET-1与sEng水平在术后复发的Stanford B型主动脉夹层患者中呈高表达,通过术前监测上述指标变化可有效评估Stanford B型主动脉夹层术后复发风险,为制定个体化治疗方案提供有力依据。Objective To analyze soluble intercellular adhesion molecule-3(sICAM-3),endothelin-1(ET-1)and endothelin(Soluble Endoglin,soluble endoglin,soluble endoglin,soluble intercellular adhesion molecule-3(SICAM-3)in serum and to evaluate the value of combined tests of sEndoglin(sEng)levels in the risk assessment of recurrence after aortic dissection.Methods A total of 102 patients who underwent Stanford Type B aortic dissection at the Second Hospital of Hebei Medical University from March 2018 to May 2023 were retrospectively included.These patients were divided into a recurrence group(16 cases)and a non-recurrence group(86 cases).The general data,sICAM-3,ET-1 and sEng levels were compared between the two groups.The risk factors for postoperative recurrence of aortic dissection were analyzed,and an ROC curve was drawn to evaluate the predictive value of sICAM-3,ET-1,and sEng alone and in combination on the risk of postoperative recurrence of aortic dissection.Results Comparison of age,gender,history of smoking,history of drinking,history of diabetes,history of hypertension and Marfan syndrome between the recurrence group and non-recurrence group,the difference was not statistically significant(P>0.05).The proportion of individuals in the recurrence group≥60 years old,combined Marfan syndrome and branch involvement>6 was higher than that in the non-recurrence group,and the difference was statistically significant(P<0.05).The levels of sICAM-3,ET-1,and sEng in the recurrence group were significantly higher than those in the non-recurrence group,and the differences were statistically significant(P<0.05).Logistic multivariate analysis showed that age≥60 years old,Marfan syndrome,the number of branches involved>6,sICAM-3,ET-1,and sEng levels were all increased risk factors for postoperative recurrence of aortic dissection(P<0.05).According to the ROC curve,the sensitivity and specificity of sICAM-3,ET-1,and sEng in predicting the risk of recurrence after aortic dissection were 89.60%and 88.30%,respectively.The AUC was 0.

关 键 词：主动脉夹层术 可溶性细胞间粘附分子3 内皮素1 可溶性内皮抑素 

分 类 号：R654.3[医药卫生—外科学]