下肢动脉粥样硬化闭塞症患者C型凝集素样受体-2水平与介入术后2年支架内再狭窄的关系

The relationship between C-type lectin-like receptor-2 levels and in-stent restenosis in patients with lower extremity atherosclerotic occlusive disease within two years after intervention therapy

目的探讨下肢动脉粥样硬化闭塞症(LEAOD)患者支架植入术后血浆C型凝集素样受体(CLEC)-2水平与术后2年支架内再狭窄的关系。方法选取2016年3月至2018年2月在安顺市人民医院就诊的103例LEAOD患者作为研究对象。采用酶联免疫吸附法检测血浆中CLEC-2水平,分析其与介入术后支架内再狭窄的关系。结果103例患者支架植入术均获成功并随访2年。41例(39.8%)发生支架内再狭窄。再狭窄组和未狭窄组患者血浆CLEC-2水平随时间进展呈降低趋势(P<0.05)。术后7 d血浆CLEC-2评价支架内再狭窄的效能,显著高于术前和术后1 d CLEC-2(P<0.001)。多因素logistic回归分析显示,泛大西洋学会联盟(TASC)Ⅱ分型、术后7 d CLEC-2是LEAOD介入术后支架内再狭窄的独立危险因素(P<0.05)。结论血浆CLEC-2是LEAOD支架植入术后支架内再狭窄的独立危险因素。检测血浆CLEC-2有助于判断LEAOD介入术后再狭窄。

Objective To investigate the relationship between plasma C-type lectin-like receptor-2(CLEC-2) levels and in-stent restenosis in patients with lower extremity atherosclerotic occlusive disease(LEAOD) within 2 years after interventional therapy. Methods A total of 103 patients with LEAOD, who were admitted to the Anshun Municipal People’s Hospital of China between March 2016 and February 2018,were selected as the research subjects. The plasma CLEC-2 level was tested by using enzyme-linked immunosorbent assay, and its relationship with in-stent restenosis after interventional treatment of LEAOD was analyzed. Results Successful stent implantation was accomplished in all 103 patients, and the patients were followed up for 2 years. In-stent restenosis occurred in 41 patients(39.8%). In both restenosis group and nonrestenosis group the plasma CLEC-2 level showed a trend to decline over time(P <0.05). In judging the occurrence of in-stent restenosis, the postoperative 7-day plasma CLEC-2 level was remarkably more valuable than preoperative and postoperative one-day plasma CLEC-2 levels(P<0.001). Multivariate logistic regression analysis showed that Trans-Atlantic Inter-Society Consensus(TASC) Ⅱ classification type and postoperative7-day CLEC-2 level were the independent risk factors for in-stent restenosis after interventional treatment of LEAOD(P<0.05). Conclusion In patients with LEAOD, the plasma CLEC-2 level is an independent risk factor for post-stenting in-stent restenosis, and the detection of plasma CLEC-2 level is helpful for determining the occurrence of post-stenting in-stent restenosis.(J Intervent Radiol, 2021, 30: 498-501)