覆膜支架腔内修复术对Stanford B型主动脉夹层动脉瘤患者术后血清血管内皮生长因子、核因子-κB水平的影响

Effect of Endovascular Stent-graft repair on the Serum Vascular Endothelial Growth Factor and Nuclear Factor-κB Levels in Patients with Stanford Type B Aortic Dissection

目的:分析覆膜支架腔内修复术对Stanford B型主动脉夹层动脉瘤患者术后血清血管内皮生长因子(VEGF)、核因子-κB(NF-κB)水平的影响。方法:选取2015年6月~2017年6月空军军医大学第一附属医院收治的150例Stanford B型主动脉夹层动脉瘤患者,根据治疗方法不同分为两组。对照组(75例)采用药物治疗,观察组(75例)采用覆膜支架腔内修复术治疗,对比两组治疗前后血清血管内皮生长因子(VEGF)、核因子-KB(NF-κB)、白细胞介素-1β(IL-1β)、干扰素-γ(IFN-γ)、急性生理和慢性健康状况(Acute physiology and chronic health evaluation,APACHEⅡ)评分、SF-36量表评分的变化,并发症(内漏、动脉栓塞、左上肢乏力、支架后移等)发生情况,再次手术或介入治疗发生率及病死率。结果:治疗后,观察组血清VEGF、NF-κB、IL-1β、IFN-γ水平显著低于对照组(P<0.05);两组治疗后APACHEⅡ评分均较治疗前降低,SF-36量表评分均较治疗前升高,且观察组APACHEⅡ与SF-36量表评分改善程度大于对照组(P<0.05);观察组并发症总发生率4%、再次手术或介入治疗发生率为5.33%,病死率为1.33%,均显著低于对照组(17.33%、21.33%、10.67%,P<0.05)。结论:覆膜支架腔内修复术能显著提高Stanford B型主动脉夹层动脉瘤患者生活质量与生存率,并发症与再治疗发生率,改善其病情,可能降低VEGF、NF-κB水平有关。

Objective: To analyze the effects of endovascular stent-graft repair on serum vascular endothelial growth factor(VEGF) and nuclear factor-kappaB(NF-κB) levels in patients with Stanford type B aortic dissection. Methods: A total of 150 Stanford type B aortic dissection aneurysms admitted to the First Affiliated Hospital of Air Force Military Medical University from June 2015 to June 2017 were divided into two groups according to different treatment methods. The control group(75 cases) was treated with drugs,and the observation group(75 cases) was treated with stent-graft endovascular repair. Serum vascular endothelial growth factor(VEGF)and nuclear factor-KB(NF-κB) were compared before and after treatment. Interleukin-1β(IL-1β), interferon-γ(IFN-γ), acute physiology and chronic health evaluation(APACHE II) score, SF-36 scale score change, the complication(endoleak, arterial embolism, left upper limb weakness, stent displacement, etc.), the incidence and mortality of reoperation or interventional therapy. Results: After treatment,the levels of serum VEGF, NF-κB, IL-1β and IFN-γ in the observation group were significantly lower than those in the control group(P<0.05). The APACHE II scores in the two groups were lower than those before treatment, and the amount of SF-36 was decreased.Table scores were higher than those before treatment, and the improvement of APACHE II and SF-36 scales in the observation group was greater than that in the control group(P<0.05). The total incidence rate of complications in the observation group was 4%, and the incidence of reoperation or interventional treatment rate was 5.33%, the case fatality rate was 1.33%, which was significantly lower than those of the control group(17.33%, 21.33%, 10.67%, P<0.05). Conclusion: Intraluminal prosthesis can significantly improve the quality of life and survival rate as well as complications and retreatment rates of patients with Stanford type B aortic dissection aneurysm,besides, improve their condition, which may be related to the reduction of VEGF and NF-κB levels.