Th17/Treg balance and macrophage polarization ratio in lower extremity arteriosclerosis obliterans

Objective:To explore the balance of peripheral blood T helper 17 cells/regulatory T cell(Th17/Treg)ratio and the polarization ratio of M1 and M2 macrophages in lower extremity arteriosclerosis obliterans(ASO).Methods:A rat model of lower extremity ASO was established,and blood samples from patients with lower extremity ASO before and after surgery were obtained.ELISA was used to detect interleukin 6(IL-6),IL-10,and IL-17.Real-time RCR and Western blot analyses were used to detect Foxp3,IL-6,IL-10,and IL-17 expression.Moreover,flow cytometry was applied to detect the Th17/Treg ratio and M1/M2 ratio.Results:Compared with the control group,the iliac artery wall of ASO rats showed significant hyperplasia,and the concentrations of cholesterol and triglyceride were significantly increased(P<0.01),indicating the successful establishment of ASO.Moreover,the levels of IL-6 and IL-17 in ASO rats were pronouncedly increased(P<0.05),while the IL-10 level was significantly decreased(P<0.05).In addition to increased IL-6 and IL-17 levels,the mRNA and protein levels of Foxp3 and IL-10 in ASO rats were significantly decreased compared with the control group.The Th17/Treg and M1/M2 ratios in the ASO group were markedly increased(P<0.05).These alternations were also observed in ASO patients.After endovascular surgery(such as percutaneous transluminal angioplasty and arterial stenting),all these changes were significantly improved(P<0.05).Conclusions:The Th17/Treg and M1/M2 ratios were significantly increased in ASO,and surgery can effectively improve the balance of Th17/Treg,and reduce the ratio of M1/M2,and the expression of inflammatory factors.

Application of buried auricular point combined with Wenjing Sanhan prescription in arteriosclerosis obliterans patients with resting pain

BACKGROUND Research on the combined use of ear acupoint embedding beans and warming meridians with cold-dispersing formulas for alleviating resting pain in patients with arteriosclerosis obliterans(ASO)remains limited.AIM To explore the therapeutic efficacy of auricular point embedding beans combined with Wenjing Sanhan prescription in alleviating resting pain in patients with lower-limb ASO.METHODS A total of 100 patients with ASO experiencing resting pain who were treated at our hospital from January 2022 to January 2023 were enrolled.They were randomly allocated into two groups using a double-blind approach.The control group was treated using a warming meridian with a cold-dispersing formula,while the study group received additional treatment with ear acupoint embedding beans.The clinical efficacy,ankle-brachial artery pressure ratio,hemorheological indicators,and traditional Chinese medicine symptom scores were compared between the two groups.RESULTS The clinical efficacy rate in the study group was significantly higher(94.00%)than that in the control group(72.00%,P<0.05).Moreover,the ankle-brachial artery pressure ratio was significantly higher in the study group after treatment(P<0.05).Hemorheological parameters,including whole blood viscosity,plasma viscosity(1.83±0.11)mPa/s,fibrinogen levels(3.30±0.21)g/L,platelet adhesion rate(49.87%±10.51%),and erythrocyte aggregation index(1.79±0)were improved in the study group compared to the control group.In addition,the scores for decreased skin temperature(1.41±0.26),intermittent claudication(1.30±0.20),and resting pain(1.23±0.31)were significantly lower in the study group than those in the control group(all P<0.05).The level of oxidative stress in the study group also exhibited significant improvement(P<0.05),and the levels of inflammatory factors were considerably lower than those in the control group.CONCLUSION The combination of ear point embedding beans and Wenjing Sanhan prescription demonstrates promising clinical efficacy in alleviating resting pain associated with ASO.

Analysis of the Effect of Problem-Oriented Nursing Intervention on Patients with Lower Extremity Arteriosclerosis Obliterans in Vascular Surgery

Objective: To analyze the effect of problem-oriented nursing intervention on patients with lower extremity arteriosclerosis obliterans (ASO) in vascular surgery. Methods: The clinical data of 128 patients with lower extremity ASO in vascular surgery were selected and randomly divided into groups A and B, with 64 cases each. Group A is the control group, and Group B is the observation group. Group A received the routine nursing intervention, and Group B received the problem-oriented nursing intervention. The compliance, self-care ability, psychological state, quality of life, and nursing satisfaction of the two groups of patients were evaluated based on various indicators. Results: After the intervention, the evaluation of self-care ability (ESCA) score of the patients in Group B was higher than that of Group A, and the symptom checklist-90 (SCL-90) score was lower than that of Group A. The differences were significant (t = 10.019, t = 3.118, P < 0.01). After the intervention, the World Health Organization Quality of Life Brief (WHOQOL-BREF) index scores of the two groups increased and the increase in Group B was significantly higher than Group A (P < 0.001). The compliance rate of Group B (62/ 96.88%) was higher than that of Group A (52/ 81.25%), and the difference was extremely significant (χ2 = 8.020, P < 0.01). Conclusion: Problem-oriented nursing intervention for patients with lower extremity ASO in vascular surgery improved the patient’s self-care ability, and quality of life, reduced the patient’s negative emotions, and enhanced their overall satisfaction.

The Inhibitory Effect of Astilbin on the Arteriosclerosis of Murine Thoracic Aorta Transplant

The inhibitory effect of astilbin on transplant arteriosclerosis in murine model of thoracic aorta transplantation was examined. Model of rat thoracic aorta transplantation was established. Ninety rats were divided into three groups. In isograft group, the thoracic aorta of Brown Norway （BN） rat was anastomosed with the abdominal aorta of another BN rat. In allograft group, the thoracic aorta of BN rat was anastomosed with the abdominal aorta of Lewis rat. In astilbin group, the rats receiving allo-transplantation were given astilbin 5 mg/kg per day for a time of 28 days. The donor thoracic aorta and the recipient abdominal aorta were anastomosed by means of a polyethylene can- nula （inner diameter： 1.5 mm, length： 3 mm length）. The grafts were histologically examined for structural changes. The areas of arterial lumen and endatrium were calculated. Our results showed that, in the allograft group, 28 days after allografting, conspicuous proliferation of smooth muscles and infiltration with a great number of inflammatory cells were found in the tunica intima and tunica media. Astilbin significantly inhibited the proliferation of smooth muscles and ameliorated the infiltration of inflammatory cells thereyby prevent against the development of transplant arteriosclerosis. It is concluded that asltilbin can effectively prevent the development of arteriosclerosis in allotransplant by inhibiting the proliferation of smooth muscles and inhibit the proliferation of smooth muscles in tunica of intima and media and reducing infiltration of the inflammatory cells.

Clinical and prognostic features in asymptomatic and symptomatic patients with arteriosclerosis obliterans

Background: Patients with arteriosclerosis obliterans (ASO) often have co-existing atherosclerotic diseases. The purpose of this study was to examine the clinical features of patients with ASO, including the overlap of atherosclerotic risk factors, characteristics of car-diovascular events, and clinical prognosis. Method: We enrolled 205 consecutive patients who had ankle brachial index (ABI) of ?0.9 between January 2008 and December 2009. Fontaine (F) classification and clinical background were evaluated and clinical events including mortality and major adverse cardiocerebro-vascular events (MACCEs) were determined. Results: There was a high prevalence of each risk factor. Sixty- five percent of subjects had three or more of the four overlapping risk factors, including hypertension, dia- betes, dyslipidemia, and smoking. After a maximum follow-up of 800 days, the incidence of MACCEs and mortality was 46% and 10%, respectively. We divided the patients into two groups according to the presence of ASO symptoms (F1 and F2-4) and compared the incidence of events. The incidence of MACCEs and mortality in the F2-4 group was significantly higher than that in the F1 group (P = 0.048, P = 0.044, respectively). After excluding lower extremity revascularization, coronary artery disease was a common cause of MACCEs, and the mortality rates after MACCEs increased in a stepwise manner according to F classification severity (P = 0.028). Conclusion: Patients with ASO had overlapping coronary risk factors and a high incidence rate of cardiovascular events. The incidence of coronary events was common, especially in symptomatic patients, and the mortality rates after MACCEs were high in accordance with F classification severity.

Cerebrovascular hemodynamics in patients with cerebral arteriosclerosis

The present study observed hemodynamic changes in 26 patients with cerebral arteriosclerosis using a cerebral circulation dynamics detector and transcranial Doppler. In patients with cerebral arteriosclerosis the blood supply and flow rate in the bilateral carotid arteries and the blood flow rate in the anterior cerebral and middle cerebral arteries were similar to normal controls, but the cerebral vascular resistance, critical pressure and pulsatility index were increased, and cerebral arterial elasticity and cerebral blood flow autoregulation were decreased. Compared with the lesioned hemisphere of patients with cerebral infarction, the total blood supply and blood flow rate of patients with cerebral arteriosclerosis were higher. Compared with normal subjects, patients with cerebral arteriosclerosis exhibited cognitive disturbances, mainly in short-term memory, attention, abstract capability, and spatial and executive dysfunction. Results showed that cerebral arteriosclerosis does not directly affect the blood supply of a cerebral hemisphere, but affects cognitive function. The increased cerebral vascular resistance and reduced autoregulation of cerebral blood vessels may be important hemodynamic mechanisms of arteriosclerosis-induced cerebral infarction.

Potential Effects of Desalinated Seawater on Arteriosclerosis in Rats

To evaluate the potential risk of arteriosclerosis caused by desalinated seawater, Wistar rats were provided desalinated seawater over a 1-year period, and blood samples were collected at 0, 90, 180, and 360 days. Blood calcium, magnesium, and arteriosclerosis-related indicators were investigated. Female rats treated with desalinated seawater for 180 days showed lower magnesium levels than the control rats （P 〈 0.05）. The calcium and magnesium levels in female rats and the magnesium level in male rats were lower than the levels in the controls, following treatment with desalinated seawater for 360 days （P 〈 0.05）. Blood levels of arteriosclerosis-related lipid peroxidation indicators and C-reactive protein （CRP） in the treatment group did not differ from those in the controls. The levels of lipid peroxidation indicators and CRP in rats were not significantly affected by drinking desalinated seawater, and no increase in risk of arteriosclerosis was observed.

Evaluation of effect of acupuncture treatment on carotid arteriosclerosis plaque by three-dimensional ultrasound VPQ technology

Objective:To evaluate the structural changes of atherosclerotic plaque before and after acupuncture treatment by three-dimensional ultrasound of Vascular Plaque Quantification technology.Methods:Forty subjects were recruited and randomly divided into acupuncture group and sham acupuncture group.All patients were treated twice a week for 3 months and were observed the changes of the bilateral carotid plaque volume(PV),gray scale value(GSM)and inner media thickness(IMT).Results:The acupuncture group’s PV decreased after 3 months,while the sham group’s increased slightly.The result were statistically significant(P≤0.05).After treatment,the acupuncture group’s left GSM was higher than before,while the sham group’s was slightly lower than before.The result were statistically significant(P≤0.05).Although the difference of the acupuncture group’s right GSM before and after treatment was not statistically significant,it also had a rising trend.Conclusion:Acupuncture can reduce the volume of carotid atherosclerotic plaque and stabilize the nature of the plaque.

Mechanism of Simiao Yongan decoction in the treatment of arteriosclerosis obliterans of lower extremity through JAK/STAT signaling pathway

Objective:To predict the effective components,potential targets and pathways of Simiao Yong’an Decoction in the treatment of lower extremity arteriosclerosis obliterans(ASO)based on the method of network pharmacology,and to explore the mechanism of Simiao Yong’an Decoction in treating ASO combined with cell experiment.Methods:TCMSP database was used to screen the active components and targets of Simiao Yong’an decoction,and Genecards and OMIM databases were used to obtain ASO related proteins;PPI network of drug disease target proteins was constructed by string platform;go function and KEGG pathway enrichment of Simiao Yong’an Decoction ASO target were analyzed by David database.The drug target pathway with high correlation with ASO was selected.The model of vascular smooth muscle cell injury(VSMCs)induced by ox LDL was used,and Simiao Yong’an decoction containing pharmaceutical Qing was given to verify the therapeutic effect of Simiao Yong’an Decoction on ox LDL induced VSMCs and its regulation on highly correlated target pathway.Results:A total of 126 active components of Simiao Yong'an Decoction were screened,40 targets of Simiao Yong’an Decoction ASO were selected,99 go biological processes and 48 related signal pathways were related to ASO;the experimental results showed that with the passage of time,Simiao Yongan decoction could significantly inhibit the proliferation of VSMCs(P<0.05);compared with the model group,the percentage of BrdU positive cells in each dose group of Simiao Yong’an decoction was significantly higher than that in the model group In addition,Simiao Yong’an decoction could significantly inhibit the proliferation of VSMCs(P<0.05);in addition,Simiao Yongan decoction could inhibit the levels of IL-6 and IL-1β(P<0.05);significantly inhibit the expression of PCNA,JAK2 and STAT3 mRNA(P<0.05);Conclusions:Simiao Yong’an decoction has the effect of"multi-component,multi-target and multi-channel"in the treatment of ASO.It can inhibit the activation of JAK/STAT signaling pathway,play an anti-inflammatory role and inhibit the proliferation of vascular smooth muscle cells.

Application of Big Data Deep Learning in Auxiliary Diagnosis of Lower Extremity Arteriosclerosis Obliterans

At present,the incidence rate of arteriosclerosis obliterans(LEASO)of the lower extremities is significantly increased by aging and lifestyle changes.It is of great importance to predict the LEASO effectively and accurately by analyzing the imaging data of the lower extremities⑴.At this stage,China has entered the era of big data and artificial intelligence.Medical institutions at all levels can produce a large number of lower limb vascular image data every day.Using big data deep learning technology to intelligently analyze a large number of image data,and then carry out auxiliary diagnosis,so as to improve the diagnosis and treatment effect of LEASO is the focus of clinical research.

Efficacy and safety of Danhong injection in the treatment of arteriosclerosis obliterans:a meta-analysis of randomized controlled trials

目的:系统评价丹红注射液治疗动脉硬化闭塞症的临床有效性和安全性。方法:计算机检索中国知网(CNKI)、维普中文期刊数据库(VIP)、万方数据知识服务平台、中国生物医学文献数据库(CBM)、Pubmed、科学引文索引(SCI)数据库、Cochrane Library在内的8个中英文数据库,2位研究者对符合入选标准者采用Cochrane推荐的偏倚风险评估方法评价偏倚风险,提取资料,并应用Review Manager软件进行Meta分析和系统评价。结果:最终纳入13项研究,总病例数884例,结果显示,丹红注射液治疗动脉硬化闭塞症与常规治疗方式相比较,临床有效性更高,差异有统计学意义,[OR=3.08,95%CI(2.07,4.60),P<0.00001];对动脉硬化程度改善更加明显,[OR=0.15,95%CI(0.12,0.19),P<0.00001];对血流动力学改善更加明显,[OR=-0.19,95%CI(-0.33,-0.04),P=0.01];未有任何不良反应发生。结论:丹红注射液治疗动脉硬化闭塞症,临床有效性更高,对动脉硬化程度和血流动力学改善更加明显,且具有较高安全性。但由于文献研究质量偏低,需要更多高质量、大样本、随机对照双盲临床试验提供高级别证据,以进一步验证丹红注射液治疗动脉硬化闭塞症有效性和安全性。

THE STUDY APPLIED ON BA IN DIAGNOSIS OF CEREBRAL ARTERIOSCLEROSIS

目的:探讨脑电地形图在脑动脉硬化诊断中的应用价值。方法:90例脑动脉硬化患者进行了脑电地形图及脑CT检查,并两者进行了对比。结果:90例脑动脉硬化患者的脑电地形图改变是明显的,与脑CT对比有显著差异,P<0.01。结论:脑电地形图在脑动脉硬化患者诊断中有重要价值。

基于《黄帝内经》气虚理论对动脉粥样硬化论治探微

动脉粥样硬化是心血管疾病的病理基础。本虚标实为动脉粥样硬化的基本病机。从《黄帝内经》气虚理论出发,以五脏及营卫之气的虚损作为切入点,探讨其影响津液血液运行从而产生“痰瘀毒”等病理产物的作用机制,探讨动脉粥样硬化的病因病机。治疗上应以补益为主,佐以活血化瘀之法。

下肢动脉硬化闭塞症患者生活质量及影响因素分析

目的:分析下肢动脉硬化闭塞症患者生活质量及影响因素,为改善患者生活质量提供依据。方法:采用便利抽样法,选取2022年6月—11月重庆市某三级甲等医院下肢动脉硬化闭塞症患者302例为调查对象,采用疼痛程度数字评分量表、生活自理能力评分量表和中文修订版外周动脉疾病生活质量量表评估其生活质量。应用SPSS22.0统计学软件,采用ANOVA方差分析及多元逐步回归分析等方法进行统计、分析。结果:下肢动脉硬化闭塞症患者生活质量评分为(57.22±13.69)分。不同居住地、个人平均月收入、医疗费用支付方式、步行距离、疼痛分级、生活自理能力评定结果、吸烟年限患者的生活质量得分比较,差异具有统计学差异(P<0.05)。多元逐步回归分析结果显示,生活质量的3个影响因素为疼痛分级、生活自理能力评定结果、步行距离。结论:下肢动脉硬化闭塞症患者总体生活质量差,其主要影响因素为疼痛、生活自理能力和步行距离。提示临床应加强对高危人群的早期筛查,早诊断、早治疗,从而改善下肢动脉硬化闭塞症患者生活质量。

幽门螺杆菌碳13阳性与冠状动脉严重钙化的相关性分析

目的:探讨幽门螺杆菌碳13呼气试验阳性与冠状动脉钙化严重程度的的相关性。方法:连续入选2021年6月至2023年11月,某三甲医院体检中心体检人员,采集体检人群幽门螺杆菌检测结果,共入选485例,平均年龄(56.6±9)岁,其中男性343例(70.3%)。以及冠状动脉CT结果,并根据冠状动脉钙化积分(coronary artery calcium score,CACS)分为两组,分别为严重钙化组(CACS>400,55例)及(CACS≤400,430例)。结果:入选资料完整体检人群485例,其中幽门螺杆菌阳性126例(26.0%),冠状动脉CTA结果显示冠状动脉严重钙化(钙化积分高于400)共55例(11.3%)。严重钙化组平均年龄显著高于CACS≤400人群[(63.5±8.9)vs.(55.6±8.8),P<0.01],严重钙化组吸烟、饮酒比率高于钙化积分<400组,SBP、FBG、LDL-C水平两组差异有统计学意义。不同冠状动脉钙化程度体检人员的幽门螺杆菌阳性率,差异有统计学意义(P<0.05)。严重钙化组碳13水平(9.9±15.2),碳13阳性占41.8%,钙化积分<400组碳(135.5±9.9),13C-UBT阳性占23.8%(P均<0.05)。严重钙化组颈动脉斑块比率显著高于CACS≤400组。HP阳性组冠状动脉严重钙化比率显著高于HP阴性组(18.3%vs.8.9%,P=0.004)。HP阳性组心率相对高、HDL-C水平相对低(P均<0.05)。多因素Logistic分析分析显示:年龄、吸烟、血脂是冠状动脉钙化的危险因素,与幽门螺杆菌阴性相比,幽门螺杆菌阳性者发生冠状动脉严重钙化的风险相对高(OR=2.100,95%CI:1.094~4.029,P=0.026)。结论:校正传统的心血管危险因素后,幽门螺杆菌阳性患者具有相对高的冠状动脉粥样硬化风险。

CT血管造影对下肢动脉硬化闭塞症介入治疗效果评价及术后复发预测价值研究

目的探讨CT血管造影(CTA)对下肢动脉硬化闭塞症(ASO)介入治疗效果评估及术后复发预测价值。方法选择130例ASO患者,其中男性81例,女性49例;年龄50~67岁,平均年龄58.92岁(标准差5.04岁);身体质量指数(BMI)21~27 kg/m^(2),平均BMI 24.28 kg/m^(2)(标准差1.33 kg/m^(2));高血压51例,糖尿病56例,冠心病57例;吸烟85例。均给予介入手术治疗及CTA检查,比较手术前后下肢动脉狭窄程度、斑块参数[斑块负荷(PB)、斑块面积(PA)、最小管腔面积(MLA)]。对所有患者进行为期1年的随访,根据ASO是否复发,分为复发组和未复发组,比较两组斑块参数,绘制受试者工作特性(ROC)曲线,计算曲线下面积(AUC),分析PB、PA、MLA对ASO复发的预测价值。Logistic回归分析ASO复发的危险因素。结果术后中度狭窄(23.08%)、重度狭窄(19.23%)、完全闭塞率(3.08%)均低于术前(30.77%、46.15%、13.85%)(P<0.05)。术后PB、PA、MLA均低于术前[(29.82±4.11)%vs(62.82±8.16)%、(4.26±0.26)mm^(2)vs(9.26±1.33)mm^(2)、(3.01±0.17)mm^(2)vs(7.16±1.05)mm^(2)。P<0.05]。随访1年后,根据复发情况分为复发组28例和未复发组102例。复发组PB(57.63±4.28)%、PA(9.02±1.27)mm^(2)、MLA(6.96±1.01)mm^(2)均高于未复发组[(28.11±3.85)%、(4.07±1.07)mm^(2)、(2.85±0.12)mm^(2)。t=35.077、20.805、40.474,P<0.05]。PB、PA、MLA联合检测预测ASO复发的AUC是0.792[95%可信区间(CI)0.716~0.954],灵敏度、特异度分别是93.08%、91.13%,均高于单一检测(P<0.05)。高血压、糖尿病、血管闭塞长度、术后用药不规律、C反应蛋白(CRP)是ASO复发的危险因素(P<0.05)(OR=1.268、1.216、1.134、1.329、1.226;95%CI=1.135~1.438、1.128~1.395、1.034~1.296、1.162~1.468、1.133~1.429)。结论CTA可准确评估ASO患者下肢动脉狭窄程度,辅助临床评估治疗效果,提高对疾病复发的预测灵敏度及特异度,ASO的复发与多种因素有关,应当引起临床重视与关注。

血管减压联合药物涂层球囊对股腘动脉硬化性闭塞症患者早期疗效及其机制分析

目的探讨血管减压联合药物涂层球囊对股腘动脉硬化性闭塞症患者早期疗效及其机制。方法选择2020年1月至2022年5月于合肥市第一人民医院就诊的82例股腘动脉硬化性闭塞症患者为研究对象。采用随机数字表法将患者分为对照组(n=41,行药物涂层球囊治疗)与观察组(n=41,行血管减压联合药物涂层球囊治疗)。比较两组患者临床疗效、动脉硬化相关指标、血流动力学参数、血小板活化因子水平及并发症发生情况。结果观察组患者总有效率为92.69%(38/41),高于对照组患者的75.61%(31/41),差异均有统计学意义(P﹤0.05)。治疗后,两组患者股腘动脉内中膜厚度、脉搏波传导速度均低于本组治疗前,且观察组患者股腘动脉内中膜厚度、脉搏波传导速度均低于对照组患者;治疗后,两组患者踝臂血压指数均高于本组治疗前,且观察组患者踝臂血压指数高于对照组患者,差异均有统计学意义(P﹤0.05)。治疗后,两组患者全血黏度、血浆黏度、纤维蛋白原水平均低于本组治疗前,且观察组患者全血黏度、血浆黏度、纤维蛋白原水平均低于对照组患者,差异均有统计学意义(P﹤0.05)。治疗后,两组患者可溶性CD40配体、sP选择素均高于对照组患者,且观察组患者可溶性CD40配体、sP选择素均高于对照组患者,差异均有统计学意义(P﹤0.05)。两组患者并发症发生率比较,差异无统计学意义(P﹥0.05)。结论血管减压联合药物涂层球囊治疗较单独行药物涂层球囊治疗可有效提高股腘动脉硬化性闭塞症患者早期疗效,改善患者动脉硬化相关指标、血流动力学参数,但却在一定程度上导致血小板活化因子水平升高。

下肢动脉硬化闭塞症生活质量问卷的汉化及信效度评价

目的汉化外周动脉疾病生活质量问卷,并检验其信效度。方法在取得原作者同意并授权的情况下,根据Brislin模型对原问卷进行翻译、回译、文化调适及预调查,形成中文版下肢动脉硬化闭塞症生活质量问卷。采用便利抽样法,于2022年8月至2023年5月选取河南省人民医院135例下肢动脉硬化闭塞症患者实施调查,检验中文版下肢动脉硬化闭塞症生活质量问卷的信效度。结果中文版下肢动脉硬化闭塞症生活质量问卷包括6个维度,12个条目。问卷的内容效度为0.98,Cronbach'sα系数为0.899,各维度的Cronbach'sα系数为0.637~0.884,折半信度为0.805,重测信度为0.696,校标关联效度为-0.712(P<0.01)。探索性因子分析提取6个因子,累计方差贡献率为87.332%。结论中文版下肢动脉硬化闭塞症生活质量问卷具有良好的信效度,可作为下肢动脉硬化闭塞症患者生活质量的评估工具。

下肢动脉血管重建术后并发淋巴漏的风险预测列线图模型建立及预防指导

目的探讨下肢动脉血管重建术后并发淋巴漏的影响因素,并以此构建风险预测列线图模型,同时提出相对应的预防指导建议。方法回顾性分析于2014年1月至2022年6月在徐州市中心医院行下肢动脉血管重建的879例下肢动脉硬化闭塞症(LEASO)病人的临床资料,根据病人术后有无并发淋巴漏将其分为并发组(31例)和未并发组(848例),比较两组病人的一般资料。采用多因素logistic回归分析法分析下肢动脉血管重建术后并发淋巴漏的影响因素,并基于此采用R 3.4.5软件包绘制列线图模型,且绘制受试者工作特征(ROC)曲线对列线图模型的预测效能进行评估,绘制校准度曲线图并采用Bootstrap法检验预测列线图预测模型的一致性。结果单因素分析显示,两组身体质量指数(BMI)[(26.52±2.01)kg/m^(2)比(25.71±2.13)kg/m^(2)]及Fontaine分期[Ⅳ期38.71%比18.28%]、术中出血量[>100 mL 29.03%比11.20%]、术后血红蛋白(Hb)水平[(95.33±15.25)g/L比(104.57±22.38)g/L]、术后白蛋白(Alb)水平[(25.68±5.59)g/L比(28.28±6.17)g/L]、使用高频电刀(83.87%比55.54%)、腹股沟切口(80.65%比56.25%)差异有统计学意义(均P<0.05)。logistic回归分析可知,BMI[OR=2.52,95%CI:(1.18,3.86)]、Fontaine分期[OR=3.22,95%CI:(2.08,4.36)]、术中出血量>100 mL[OR=3.36,95%CI:(2.23,4.48)]、术后Hb水平[OR=2.97,95%CI:(1.75,4.20)]、术后Alb水平[OR=3.10,95%CI:(2.02,4.19)]、使用高频电刀[OR=3.39,95%CI:(2.20,4.59)]、腹股沟切口[OR=3.31,95%CI:(2.00,4.62)]均是影响LEASO病人下肢动脉血管重建术后并发淋巴漏的独立危险因素(P<0.05)。据此构建预测LEASO病人下肢动脉血管重建术后并发淋巴漏的列线图模型,预测值同实测值基本一致,一致性指数为0.836,模型具有良好的精准度和区分度。结论BMI、Fontaine分期、术中出血量>100 mL、术后Hb水平、术后Alb水平、使用高频电刀、腹股沟切口均为影响LEASO病人下肢动脉血管重建术后并发淋巴漏的影响因素,基于上述因素构建的列线图模型效能高。

巧克力球囊扩张血管成形术在股腘动脉病变中的临床应用

目的探讨巧克力球囊扩张血管成形术治疗股腘动脉病变的有效性及安全性。方法选取2021年8月至2022年12月于北京大学深圳医院诊治的65例股腘动脉硬化闭塞疾病患者为研究对象,根据随机数字表法将患者分为试验组(n=32,采用巧克力球囊)与对照组(n=33,采用普通球囊)。比较两组患者技术成功率、治疗成功率、临床疗效、炎症因子水平、术后踝肱指数(ABI)、血管通畅情况。结果试验组患者技术成功率、治疗成功率为100%、93.75%,均高于对照组患者的96.97%、81.82%,但差异均无统计学意义(P﹥0.05)。试验组患者夹层发生率为6.25%,低于对照组患者的24.24%,差异有统计学意义(P﹤0.05)。治疗后,试验组患者C反应蛋白(CRP)、白细胞介素-6(IL-6)水平均低于对照组患者,差异均有统计学意义(P﹤0.05)。术后1个月,两组患者ABI均高于本组术前,且试验组患者ABI高于对照组患者,差异均有统计学意义(P﹤0.05)。两组患者术后治疗效果比较,差异无统计学意义(P﹥0.05)。结论巧克力球囊扩张血管成形术治疗股腘动脉硬化闭塞疾病的近期疗效优于普通球囊,且炎症控制较好,夹层的发生率较低。