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.
作者
张超
张小晶
杨小军
梁萧
林友杰
ZHANG Chao;ZHANG Xiaojing;YANG Xiaojun(Linfen People's Hospital,Shanxi Linfen 041099,China)
出处
《河北医学》
CAS
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)。
