血清25(OH)D3、OPG水平与大脑中动脉狭窄患者支架置入术后再狭窄的相关性

Correlation between serum 25(OH)D3, OPG levels and restenosis in patients with middle cerebral artery stenosis after stent implantation

目的观察血清25-羟维生素D3[25(OH)D3]、骨保护素(OPG)水平与大脑中动脉(MCA)狭窄患者支架置入术后再狭窄的关系。方法回顾性分析2017年1月至2019年12月平顶山市第一人民医院完成支架置入手术治疗及术后随访的89例MCA狭窄患者的临床资料,根据术后6个月再狭窄情况分组,将再狭窄25例纳入再狭窄组,其他64例设为未狭窄组;另收集同期本院体检中心50例健康体检者设为对照组。分别于对照组体检当天、支架置入术患者入院时,出院时,术后3、6个月,检测血清25(OH)D3、OPG水平;分析血清25(OH)D3、OPG水平与MCA狭窄患者支架置入术后再狭窄的相关性。结果入院时,未狭窄组、再狭窄组血清25(OH)D3水平低于对照组,OPG水平高于对照组(P<0.05);且再狭窄组入院时、出院后各时点血清25(OH)D3水平低于未狭窄组,OPG水平高于未狭窄组,差异有统计学意义(P<0.05);血清25(OH)D3与OPG水平呈负相关(r<0,P<0.05);二元Logistics回归分析结果显示,血清25(OH)D3低表达、OPG过表达可能是导致MCA狭窄患者支架置入术后再狭窄的影响因素(OR>1,P<0.05)。结论MCA狭窄患者血清25(OH)D3低表达、OPG过度表达对支架置入术后再狭窄有影响,二者对预测MCA狭窄患者支架置入术后再狭窄发生有一定价值,动态监测其水平变化可为再狭窄的早期预测与干预提供重要参考。

Objective To observe the relationship between serum 25-dihydroxyvitamin D3[25(OH)D3],osteoprotegerin(OPG)levels and restenosis in patients with middle cerebral artery(MCA)stenosis after stent implantation.Methods The clinical data of 89 patients with MCA stenosis who underwent stent implantation and postoperative follow-up in the First People’s Hospital of Pingdingshan from January 2017 to December 2019 were collected.The patients were divided into groups according to the restenosis after surgery for 6 months,25 patients with restenosis were included in restenosis group,and the other 64 cases were taken as non-stenosis group;50 healthy controls in the medical examination center of the hospital during the same period were taken as control group.The serum levels of 25(OH)D3 and OPG were detected on the day of physical examination in control group,and on admission,on discharge,after surgery for 3 months,and 6 months in patients with stent implantation;the correlation between serum indexes and restenosis in patients with MCA stenosis after stent implantation was analyzed.Results On admission,the level of serum 25(OH)D3 in non-stenosis group and stenosis group was lower than that in control group,and the level of OPG was higher than that in control group(P<0.05);on admission and at each time after discharge,the levels of serum 25(OH)D3 in stenosis group were lower than those in non-stenosis group,and the level of OPG was higher than that in non-stenosis group(P<0.05);serum 25(OH)D3 was negatively correlated with OPG level(r<0,P>0.05);the results of binary Logistic regression analysis showed that low expression of serum 25(OH)D3 and over-expression of OPG may be the influencing factors of restenosis after stent implantation in patients with MCA stenosis(OR>1,P<0.05).Conclusions Low expression of serum 25(OH)D3 and over-expression of OPG have an effect on restenosis after stent implantation.Both have certain value in predicting the occurrence of restenosis after stent implantation in patients with MCA stenosis,and dynamic monitoring of their changes can provide an important reference for early prediction and intervention of restenosis.