摘要
目的探讨血清嗅素蛋白-2(OLFM-2)、内皮素-1(ET-1)、可溶性髓系细胞触发受体-1(sTREM-1)预测下肢动脉硬化闭塞症(LASO)患者支架植入术后血管再发狭窄的价值。方法选取2017年1月至2019年12月在该院介入疼痛科接受支架植入术治疗的LASO患者140例作为研究对象。采用酶联免疫吸附试验法检测血清OLFM-2、ET-1、sTREM-1水平。比较LASO患者治疗前后血清OLFM-2、ET-1、sTREM-1水平差异。随访1年,根据患者术后血管有无再发狭窄,分为再狭窄组(n=58)与未再狭窄组(n=82)。采用受试者工作特征(ROC)曲线和Logistic回归分析术后血清OLFM-2、ET-1、sTREM-1对LASO患者支架植入术后血管再发狭窄的预测价值。结果LASO患者治疗后血清OLFM-2、ET-1、sTREM-1水平明显高于治疗前血清OLFM-2、ET-1、sTREM-1水平,差异有统计学意义(P<0.05)。再狭窄组患者血清OLFM-2、ET-1、sTREM-1水平与未再狭窄组患者比较,差异有统计学意义(P<0.05)。ROC曲线分析结果显示,术后血清OLFM-2、ET-1、sTREM-1预测LASO患者支架植入术后血管再发狭窄的最佳临界值分别为27.35 ng/mL、97.36 pg/mL、317.30 ng/L,曲线下面积(AUC)分别为0.823(95%CI:0.722~0.923,P<0.001)、0.787(95%CI:0.679~0.897,P<0.001)、0.799(95%CI:0.688~0.910,P<0.001),三者联合检测可将AUC提高至0.904(95%CI:0.831~0.977,P<0.001)。LASO患者下肢动脉病变长度长、下肢动脉完全闭塞、泛大西洋学会联盟分型C型+D型及术后血清OLFM-2、ET-1、sTREM-1水平升高是LASO患者支架植入术后血管再发狭窄独立危险因素(P<0.05)。结论血清OLFM-2、ET-1、sTREM-1水平在LASO患者支架植入术后血管再发狭窄患者中明显升高,术后三项联合检测OLFM-2、ET-1、sTREM-1对评估LASO患者支架植入术后血管再发狭窄有较高临床价值。
Objective To investigate the value of serum olfactomedin-2(OLFM-2),endothelin-1(ET-1)and soluble triggering receptor expressed on myeloid cells-1(sTREM-1)in predicting vascular restenosis after stent implantation in patients with lower extremity arteriosclerosis obliterans(LASO).Methods A total of 140 LASO patients who received stenting in the interventional pain department of a hospital from January 2017 to December 2019 were selected as the study subjects.Serum levels of OLFM-2,ET-1 and sTREM-1 were detected by enzyme-linked immunosorbent assay.The serum levels of OLFM-2,ET-1 and sTREM-1 in LASO patients were compared before and after treatment.Patients were followed up for 1 year and were divided into restenosis group(n=58)and non-restenosis group(n=82)according to whether they had recurrent vascular stenosis after surgery.Receiver operating characteristic(ROC)curve and Logistic regression were used to analyze the predictive value of postoperative serum OLFM-2,ET-1,and sTREM-1 on vascular restenosis after stenting in LASO patients.Results The levels of OLFM-2,ET-1 and sTREM-1 in serum of LASO patients after treatment were significantly higher than those before treatment,and the difference was statistically significant(P<0.05).The serum levels of OLFM-2,ET-1 and sTREM-1 in restenosis group were significantly different from those in non-restenosis group(P<0.05).ROC curve analysis results showed that the optimal critical values of postoperative serum OLFM-2,ET-1 and sTREM-1 to predict the recurrence of vascular stenosis after stent implantation in LASO patients were 27.35 ng/mL,97.36 pg/mL and 317.30 ng/L,respectively.The area under the curve(AUC)was 0.823(95%CI:0.722—0.923,P<0.001),0.787(95%CI:0.679—0.897,P<0.001)and 0.799(95%CI:0.688—0.910,P<0.001),respectively,the combined detection of the three could increase the AUC to 0.904(95%CI:0.831—0.977,P<0.001).In LASO patients,the long length of lower extremity artery lesions,complete occlusion of lower extremity artery,trans-atlantic inter-society consensus type C+D and postoperative serum OLFM-2,ET-1 and sTREM-1 levels were independent risk factors for restenosis after stent implantation in LASO patients(P<0.05).Conclusion Serum levels of OLFM-2,ET-1 and sTREM-1 are significantly increased in patients with vascular restenosis after stent implantation in LASO patients.Postoperative three combined detection of OLFM-2,ET-1,sTREM-1 has a high clinical value in the evaluation of vascular restenosis after stent implantation in LASO patients.
作者
卫飞鹏
王国壮
WEI Feipeng;WANG Guozhuang(Department of Interventional Pain,Second Affiliated Hospital of PLA Air Force Medical University,Xi′an,Shaanxi 710038,China)
出处
《国际检验医学杂志》
CAS
2024年第15期1844-1848,1855,共6页
International Journal of Laboratory Medicine
基金
陕西省重点研发计划项目(S2020-YBSF-0042)。
关键词
嗅素蛋白-2
内皮素-1
可溶性髓系细胞触发受体-1
下肢动脉硬化闭塞症
血管再发狭窄
olfactomedin-2
endothelin-1
soluble triggering receptor expressed on myeloid cells-1
lower extremity arteriosclerosis obliterans
vascular restenosis
