sTWEAK、sCD163水平与ASO介入治疗术后再狭窄的相关性分析

Relationship between plasma levels of sTWEAK and sCD163 and restenosis in patients with lower extremity arteriosclerosis obliterans after interventional therapy

目的 探讨血浆可溶性TWEAK(soluble TWEAK,s TWEAK)、可溶性CD163(soluble CD163,sCD163)水平与下肢动脉硬化闭塞症(arteriosclerosis obliterans,ASO)介入治疗术后再狭窄(in-stent restenosis,ISR)的关系。方法 选择2018年1月至2019年12月在浙江省湖州市长兴县中医院就诊的263例ASO患者作为研究对象,根据1年内是否发生ISR将患者分为ISR组(n=81)和非ISR组(n=182)。观察两组患者sTWEAK、sCD163、sTWEAK/sCD163及其他临床资料差异,采用多因素分析sTWEAK、sCD163、sTWEAK/sCD163对ISR的影响,采用受试者操作特征(receiver operator characteristic,ROC)曲线计算有关指标对ISR的预测价值。结果 ISR发生率为26.60%。ISR组患者sTWEAK、sTWEAK/sCD163水平低于非ISR组患者,sCD163水平和hs-CRP水平高于非ISR患者,差异均有统计学意义(P<0.05)。ISR组和非ISR组患者吸烟、收缩压(systolic blood pressure,SBP)、糖化血红蛋白(glycated hemoglobin,HbA1c)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、Rutherford分级、病变长度、完全闭塞、最小管腔直径、管腔狭窄率相比较,差异存在统计学意义(P<0.05)。多因素分析显示,s TWEAK/sCD163是ISR的保护性因素(P<0.05),吸烟、HbA1c、病变长度、完全闭塞是ISR的风险因素(P<0.05)。ROC曲线结果显示s TWEAK/sCD163预测ISR的敏感度为80.25%,特异性为88.46%,曲线下面积为0.898,95%CI:0.855~0.932。结论 基线sTWEAK/sCD163水平是ASO介入治疗术后的保护性因素,基线水平对术后1年内ISR具有一定预测价值。

Objective To investigate the relationship between plasma levels of sTWEAK,sCD163 and restenosis(ISR)in patients with arteriosclerosis obliterans(ASO)after interventional therapy.Methods A total of 263 patients with ASO in Zhejiang Province Huzhou City Changxing Hospital of Traditional Chinese Medicine in Huzhou City of Zhejiang Province from January 2018 to December 2019 were selected as the research objects.According to whether in-stent restenosis(ISR)occurred within one year,the patients were divided into ISR group(n=81)and non ISR group(n=182).The differences of sTWAVE,sCD163,sTWAVE/sCD163 and other clinical data between the two groups were observed.Multivariate analysis was used to analyze the effects of sTWEAK,sCD163 and sTWEAK/sCD163 on ISR,and receiver operator characteristic(ROC)curve was used to calculate the predictive value of relevant indicators for ISR.Results The incidence of ISR was 26.60%.The levels of sTWEAK and sTWEAK/sCD163 in ISR patients were lower than those in non ISR patients,and the levels of sCD163 and hs-CRP in ISR patients were higher than those in non ISR patients(P<0.05).There were significant differences in smoking,systolic blood pressure(SBP),glycated hemoglobin(HbA1c),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),Rutherford grade,lesion length,total occlusion,minimum lumen diameter and stenosis rate between ISR group and non ISR group(P<0.05).Multivariate analysis showed that sTWEAK/sCD163 was the protective factor of ISR(P<0.05),and smoking,HbA1c,lesion length and total occlusion were the risk factors of ISR(P<0.05).ROC curve results showed that the sensitivity,specificity,area under the curve and 95%CI of sTWEAK/sCD163 were 80.25%,88.46%,0.898 and 0.855-0.932.Conclusion The baseline sTWEAK/sCD163 level is a protective factor after ASO intervention,and the baseline level has a certain predictive value for ISR within one year after operation.