血清高迁移率族蛋白B1、髓系细胞触发受体1对下肢动脉硬化闭塞症病人介入治疗后再狭窄的预测价值

Changes of Serum HMGB1 and TREM1 in patients with arteriosclerosis obliterans and their predictive value

目的探究血清高迁移率族蛋白B1(HMGB1)、髓系细胞触发受体1(TREM-1)对下肢动脉硬化闭塞症病人介入治疗后再狭窄的预测价值。方法2014年1月~2017年10月我院收治的70例下肢动脉硬化闭塞症病人,按照术后2年内是否发生再狭窄分为再狭窄组(31例)和对照组(39例),收集病人临床资料,检测两组术前及术后1个月血清HMGB1、TREM-1水平,分析血清HMGB1、TREM预测术后再狭窄的评估价值。结果再狭窄组和对照组血清HMGB1、TREM-1、低密度脂蛋白胆固醇(LDL)、超敏C反应蛋白(hs-CRP)水平、双侧病变之间比较,差异有统计学意义(P<0.05);Spearman相关性分析显示,术前及术后1个月血清HMGB1、TREM-1与LDL、hs-CRP水平均呈正相关(P<0.05);多因素Logistic回归分析显示,术前血清HMGB1(>11.56 ng/L)、术前TREM-1(>203.47 ng/L)、术后1个月HMGB1(>16.08 ng/L)、术后1个月TREM-1(>266.41 ng/L)、LDL(>2.99 mmol/L)、hs-CRP(>1.96 mg/L)是介入治疗病人再狭窄的危险因素(P<0.05);术后1个月血清HMGB1、TREM-1联合检测的诊断效能(AUC=0.884)高于术前联合检测(AUC=0.784),差异有统计学意义(P<0.05)。结论术前及术后1个月血清HMGB1、TREM1在下肢动脉硬化闭塞症病人中均呈高表达,且术后1个月时两者联合检测对术后血管再狭窄的发生具有较好的预测价值。

Objective To investigate the Changes of high mobility group protein B1(HMGB1)and Triggering Receptor Expressed on Myeloid Cells-1(TREM-1)in patients with arteriosclerosis obliterans after interventional therapy and Their Predictive Value.Methods Seventy patients with cerebral infarction admitted to our hospital from January 2014 to October 2017 were enrolled.The clinical data of the patients were collected and divided into recurrent group(n=31)and non-recurrent group(n=39)according to whether restenosis occurred within 2 years after operation.The clinical data of patients were collected,the levels of serum HMGB1 and TREM-1 before and 1 month after operation were measured,and the evaluation value of serum HMGB1 and TREM in predicting restenosis after operation was analyzed.Results The levels of serum HMGB1,TREM-1,LDL,hs CRP levels,and bilateral lesions were higher in the restenosis group than in the control group(P<0.05).Spearman correlation analysis showed that serum HMGB1 and TREM-1 before and 1 month after operation were positively correlated with LDL and hs-CRP levels of patients with cerebral infarction(P<0.05).Multivariate logistic regression showed that preoperative serum HMGB1(>11.56 ng/L)and preoperative TREM-1(>203.47 ng/L)as well as 1-month postoperatively HMGB1(>16.08 ng/L),TREM-1(>266.41 ng/L),LDL(>2.99 mmol/L)and hs-CRP(>1.96 mg/L)were the risk factors for restenosis in patients with lower extremity arteriosclerosis occlusive interventional therapy(P<0.05).The diagnostic efficiency of combined serum HMGB1 and TREM-1(AUC=0.884)1 month after operation was higher than that of combined detection before operation(AUC=0.784)(P<0.05).Conclusion Serum HMGB1 and TREM11 month after operation were highly expressed in patients with arteriosclerosis obliterans of the lower extremities,and the combination of the two at 1 month after surgery has a good predictive value for the occurrence of postoperative restenosis.