文章摘要
冯自波,杨文波,祝友鹏,等.血管内皮生长因子及低氧诱导因子 -1α与糖尿病合并动脉狭窄病人支架植入术后再狭窄的关系研究[J].安徽医药,2022,26(1):86-90.
血管内皮生长因子及低氧诱导因子 -1α与糖尿病合并动脉狭窄病人支架植入术后再狭窄的关系研究
Relationship between vascular endothelial growth factor and hypoxia-inducible factor-1α and restenosis after stent implantation for diabetes mellitus with arterial stenosis patients
  
DOI:10.3969/j.issn.1009-6469.2022.01.020
中文关键词: 糖尿病血管病变  移植物闭塞,血管  动脉狭窄支架植入术  再狭窄  血管内皮生长因子  低氧诱导因子 -1α
英文关键词: Diabetic angiopathies  Graft occlusion, vascular  Stent implantation for arterial stenosis  Restenosis  Vascular en-dothelial growth factor  Hypoxia-inducible factor-1α
基金项目:
作者单位
冯自波 华中科技大学同济医学院附属梨园医院创面修复血管外科湖北武汉 430077 
杨文波 华中科技大学同济医学院附属梨园医院创面修复血管外科湖北武汉 430077 
祝友鹏 华中科技大学同济医学院附属梨园医院创面修复血管外科湖北武汉 430077 
张静 华中科技大学同济医学院附属梨园医院创面修复血管外科湖北武汉 430077 
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中文摘要:
      目的研究血管内皮生长因子( VEGF)及低氧诱导因子 -1α(HIF-1α)与糖尿病合并动脉狭窄病人支架植入术后再狭窄关系。方法选取 2016年 9月至 2018年 2月华中科技大学同济医学院附属梨园医院糖尿病合并动脉狭窄病人 188例,均行动脉支架植入治疗,支架植入前检测病人血清 VEGFA及 HIF-1α,糖、脂代谢指标及血清 C反应蛋白( CRP)对病人追踪随访 6个月,按是否发生冠脉再狭窄分为再狭窄组 98例,未再狭窄组 90例,比较两组病人 VEGF及 HIF-1α,糖、脂代,谢指标及血清 CRP水平差异,采用 logistic分析糖尿病合并动脉狭窄病人支架植入术后再狭窄的风险因素。采用 Pearson检验分析 VEGF、HIF-1α与 CRP的相关性。绘制受试者工作特征曲线( ROC曲线)分析 VEGFA及 HIF-1α对糖尿病合并动脉狭窄病人支架植入术后再狭窄的预测效能。结果再狭窄组及未再狭窄组病人血清,糖化血红蛋白( HbA1c)≥7.2%、总胆固醇( TC)≥5.7 mmol/L、VEGF≥
英文摘要:
      Objective To study relationship between vascular endothelial growth factor (VEGF) and hypoxia-inducible factor-1α (HIF-1α) and restenosis after stent implantation for diabetes mellitus with arterial stenosis patients.Methods One hundred and eighty-eight diabetes mellitus with arterial stenosis patients in Liyuan Hospital affiliated to Tongji Medical College from September 2016 toFebruary 2018 were selected and treated with artery stent implantation. Before stent implantation, serum VEGFA and HIF-1 α, glu-cose, lipid metabolism index and serum C reactive protein (CRP) were measured. Patients were followed up for 6 months. According towhether coronary artery stenosis occurred, patients were assigned into restenosis group (n=98); non-restenosis group (n=90). VEGF, HIF-1, glucose, lipid metabolism index and serum CRP level were compared between the two groups. The risk factors of restenosis afterstent implantation in patients with diabetes mellitus complicated with arterial stenosis were analyzed by logistic analysis. Pearson testwas used to analyze the correlation between VEGF, HIF-1α and CRP. The ROC curve was drawn, and the predictive effect of VEGFA and HIF-1 α on restenosis after stent implantation in diabetic patients with arterial stenosis was analyzed.Results There were signifi-cant difference in serum HbA1c ≥7.2% (63/98 vs. 34/90), total cholesterol (TC) ≥5.7 mmol/L (64/98 vs. 31/90), VEGF≥106.4 pg/mL (61/98 vs. 31/90), HIF-1α≥217.4 ng/mL (63/98 vs. 27/90, small dense low-density lipoprotein cholesterol (sLDLc) ≥3.4 mmol/L (62/98 vs. 40/90), CRP≥11.6 mg/L (62/98 vs. 17/90), lesions in branch arteries (71/98 vs. 41/90), stent length ≥3.4 cm (62/98 vs. 34/90), num-ber of stents more than 2 (26/98 vs. 10/90), and the proportion of stent diameter <4.2 mmin (71/98 vs. 31/90) between the restenosis group and non-restenosis group (all P<0.05). The results of logistic regression analysis showed that the levels of VEGF, HIF-1 α,hbah1c and CRP were independent risk factors of restenosis after stent implantation, and stent diameter was a protective factor (P< 0.05). The results of correlation analysis showed that VEGF, HIF-1 α and CRP levels showed a positive correlation (P<0.05). The ROC-AUC (95%CI) of VEGF, HIF-1α and CRP in the evaluation of restenosis after stent implantation for diabetes mellitus with arterial ste-nosis patients was 0.665 (0.412-0.916),0.761 (0.552-0.971) and 0.636 (0.323-0.944), respectively.Conclusion The levels of VEGF and HIF-1α in diabetes mellitus with arterial stenosis patients are closely related to restenosis after stent implantation. The detection ofVEGF and HIF-1α in patients with diabetic artery stenosis can predict the occurrence of restenosis.
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