纤维蛋白原及血管内皮功能指标与下肢动脉硬化闭塞症患者血管腔内介入治疗后发生血管再狭窄的关系研究  

Relationship between Fibrinogen and Endothelial Function Indexes and Vascular Restenosis in Patients with Arteriosclerosis Obliterans of Lower Extremities after Endovascular Intervention Therapy

作　　者：赵峰[1] 邓默[2] ZHAO Feng;DENG Mo(Department of Interventional Vascular Surgery,Affiliated Hospital of Hebei University,Baoding 071000,China;Department of Anesthesiology,Affiliated Hospital of Hebei University,Baoding 071000,China)

机构地区：[1]河北大学附属医院介入血管外科,河北省保定市071000 [2]河北大学附属医院麻醉科,河北省保定市071000

出　　处：《实用心脑肺血管病杂志》2025年第1期75-80,共6页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：河北省2023年度医学科学研究课题计划项目(20231475)。

摘　　要：目的探讨纤维蛋白原(FIB)及血管内皮功能指标与下肢动脉硬化闭塞症(LEASO)患者血管腔内介入治疗后发生血管再狭窄的关系。方法回顾性选取2021年5月—2022年9月河北大学附属医院收治的116例LEASO患者为研究对象,收集患者的临床资料,根据患者是否发生血管再狭窄将其分为再狭窄组(n=51)和非再狭窄组(n=65)。采用多因素Logistic回归分析探讨LEASO患者血管腔内介入治疗后发生血管再狭窄的影响因素;采用限制性立方样条回归分析探讨FIB、内皮素1(ET-1)、一氧化氮(NO)与LEASO患者血管腔内介入治疗后发生血管再狭窄风险的剂量-反应关系。结果再狭窄组肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)、C反应蛋白/白蛋白比值(CAR)、FIB、ET-1高于非再狭窄组,白蛋白、NO低于非再狭窄组(P<0.05)。多因素Logistic回归分析结果显示,TNF-α、CRP、白蛋白、CAR、FIB、ET-1、NO是LEASO患者血管腔内介入治疗后发生血管再狭窄的独立影响因素(P<0.05)。限制性立方样条回归分析结果显示,FIB、ET-1、NO与LEASO患者血管腔内介入治疗后发生血管再狭窄风险均具有非线性剂量反应关系(P=0.614,P_(非线性)=0.012;P=0.285,P_(非线性)=0.003;P=0.417,P_(非线性)=0.005),随着FIB、ET-1的升高、NO的降低,LEASO患者血管腔内介入治疗后发生血管再狭窄风险呈非比例的增加。结论FIB、ET-1升高是LEASO患者血管腔内介入治疗后发生血管再狭窄的危险因素,NO升高是LEASO患者血管腔内介入治疗后发生血管再狭窄的保护因素;FIB、ET-1、NO与LEASO患者血管腔内介入治疗后发生血管再狭窄风险均具有非线性剂量反应关系。Objective To explore the relationship between fibrinogen(FIB)and endothelial function indexes and vascular restenosis in patients with arteriosclerosis obliterans of lower extremity(LEASO)after endovascular intervention therapy.Methods One hundred and sixteen patients with LEASO admitted to Affiliated Hospital of Hebei University from May 2021 to September 2022 were retrospectively selected as the study subjects.Clinical data of the patients was collected,and patients were divided into the restenosis group(n=51)and the non-restenosis group(n=51)according to whether they had undergone revascularization.Multivariate Logistic regression analysis was used to explore the influencing factors of vascular restenosis in patients with LEASO after endovascular intervention therapy,and restricted cubic spline regression analysis was used to analyze the dose-response relationship between FIB,endothelin-1(ET-1),nitric oxide(NO)and the risk of vascular restenosis in patients with LEASO after endovascular intervention therapy.Results The tumor necrosis factor-alpha(TNF-α),C-reactive protein(CRP),C-reactive protein/albumin ratio(CAR),FIB,and ET-1 in the restenosis group were higher than those in the non-restenosis group,while albumin and NO were lower than those in the non-restenosis group(P<0.05).Multivariate Logistic regression analysis showed that TNF-α,CRP,albumin,CAR,FIB,ET-1,and NO were independent influencing factors of vascular restenosis in patients with LEASO after endovascular intervention therapy(P<0.05).Restricted cubic spline regression analysis showed that there was a nonlinear dose-response relationship between FIB,ET-1,and NO and the risk of vascular restenosis in patients with LEASO after endovascular intervention therapy(P=0.614,P_(nonlinear)=0.012;P=0.285,P_(nonlinear)=0.003;P=0.417,P_(nonlinear)=0.005),with the increase of FIB and ET-1 and the decrease of NO,the risk of vascular restenosis in patients with LEASO after endovascular intervention therapy increases non proportionally.Conclusion Increased FIB an

关 键 词：闭塞性动脉硬化 下肢动脉硬化闭塞症 血管内操作 纤维蛋白原 内皮素1 一氧化氮 血管再狭窄 

分 类 号：R543.5[医药卫生—心血管疾病]