摘要
目的分析下肢动脉硬化闭塞症(LEASO)患者介入手术后血清微小RNA-206(miRNA-206)水平的变化情况及临床意义。方法选取2019年9月至2021年9月于北京清华长庚医院接受手术治疗的83例LEASO患者作为LEASO组,同时选取同期80例健康体检者作为对照组。根据预后的不同将LEASO组患者分为再狭窄组(n=39)和非再狭窄组(n=44),比较LEASO组和对照组术前(入院时)血清血小板活化因子(PAF)、C反应蛋白(CRP)、miRNA-206水平,比较再狭窄组和非再狭窄组患者术后6个月时的临床特征、不同时间(术前、术后24 h、术后1个月、术后6个月)miRNA-206水平,分析LEASO患者介入手术后发生再狭窄的危险因素。采用受试者工作特征(ROC)曲线分析血清miRNA-206对LEASO患者介入手术后1个月发生再狭窄的预测价值。结果LEASO组的术前血清PAF、CRP、miRNA-206水平均明显高于对照组,差异均有统计学意义(P﹤0.01)。术后6个月,再狭窄组患者血清PAF、CRP水平均明显高于非再狭窄组患者,差异均有统计学意义(P﹤0.01)。术后1、6个月,再狭窄组患者的miRNA-206水平均高于非再狭窄组患者,差异均有统计学意义(P﹤0.05);术前、术后24 h,再狭窄组与非再狭窄组患者的miRNA-206水平比较,差异均无统计学意义(P﹥0.05)。多因素分析结果显示,miRNA-206高表达、PAF高表达、CRP高表达均是LEASO患者介入手术后发生再狭窄的独立危险因素(P﹤0.05)。ROC曲线分析结果显示,miRNA-206诊断LEASO患者术后1个月发生再狭窄的AUC为0.831(95%CI:0.803~0.942),灵敏度为91.13%,特异度为76.08%。结论miRNA-206表达水平的升高与LEASO患者介入手术后发生再狭窄有关,可以作为预测LEASO患者介入手术后发生再狭窄的标志物。
Objective To analyze the changes and clinical significance of serum microRNA-206(miRNA-206)levels in patients with lower extremity arteriosclerosis obliterans(LEASO)after interventional surgery.Method A total of 83 LEASO patients(LEASO group)who underwent surgical treatment at Beijing Qinghua Changgeng Hospital from September 2019 to September 2021 were selected.At the same time,80 healthy subjects who underwent physical examination during the same period were selected as the control group.Patients in the LEASO group were divided into the restenosis group(n=39)and the non-restenosis group(n=44)according to different prognosis outcomes.The preoperative(at admission)levels of platelet activating factor(PAF),C reactive protein(CRP),and miRNA-206 between the LEASO group and the control group were compared,and the clinical characteristics at 6 months after surgery and miRNA-206 levels at different times after surgery between the restenosis group and the non-restenosis group were compared,the risk factors for restenosis in LEASO patients after interventional surgery were analyzed.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum miRNA-206 on restenosis after interventional surgery in LEASO patients.Result The preoperative serum PAF,CRP,and miRNA-206 levels in the LEASO group were significantly higher than those in the control group,and the differences were statistically significant(P﹤0.01).Six months after the surgery,the levels of serum PAF and CRP in the restenosis group were significantly higher than those in the non-restenosis group,and the differences were statistically significant(P﹤0.01).At one and six months after the surgery,the levels of miRNA-206 in the restenosis group were higher than those in the non-restenosis group,and the differences were statistically significant(P﹤0.05).Before the surgery and 24 hours after the surgery,there was no statistically significant difference in miRNA-206 levels between the restenosis group and the non-restenosis group(P﹥0.05).The results of multivariate analysis showed that high expression of miRNA-206,PAF,and CRP were independent risk factors for restenosis in LEASO patients after interventional therapy(P﹤0.05).ROC curve analysis results showed that the AUC of miRNA-206 in diagnosing restenosis in LEASO patients one month after surgery was 0.831(95%CI:0.803-0.942),with a sensitivity of 91.13%and a specificity of 76.08%.Conclusion The up-regulation of miRNA-206 expression level is associated with restenosis in LEASO patients after interventional surgery,and could be used as a marker to predict postoperative restenosis in these patients.
作者
左东
张宇
朱怀宇
张童
Zuo Dong;Zhang Yu;Zhu Huaiyu;Zhang Tong(Department of Surgery,Tsinghua University Hospital,Beijing 100084,China;Department of Vascular Surgery,Beijing Aerospace General Hospital,Beijing 100076,China;Department of Vascular Surgery,Beijing Qinghua Changgeng Hospital,Beijing 102218,China)
出处
《血管与腔内血管外科杂志》
2023年第7期788-792,810,共6页
Journal of Vascular and Endovascular Surgery
