摘要
目的探究下肢动脉硬化闭塞症(LASO)患者血浆微小RNA-93(miR-93)水平对介入术后支架内再狭窄(ISR)的预测价值。方法选取2016年2月—2019年5月在华北理工大学附属医院就诊的184例LASO患者作为研究对象。根据LASO患者介入术后1年内是否发生ISR将其分为2组:ISR组(n=71)和非ISR组(n=113)。采用实时荧光定量PCR法检测LASO患者血浆miR-93水平,并探究其与ISR的关系。结果ISR组和非ISR组血浆miR-93水平比较,差异有时间效应、组间效应及时间和组间的交互效应(P<0.01)。术后14天miR-93诊断ISR的受试者工作特征曲线下面积、灵敏度和特异度分别为0.839、91.55%和70.80%,其诊断ISR的效能高于术前和术后7天miR-93,差异均有统计学意义(P<0.001)。多因素Logistic回归分析结果显示血管闭塞长度、术后14天miR-93、低密度脂蛋白胆固醇和C反应蛋白是影响LASO患者ISR的独立危险因素(P<0.01)。限制性立方样条拟合Logistic回归分析结果显示miR-93与LASO患者ISR有关(P<0.001),且呈非线性关系(P=0.009)。结论LASO患者血浆miR-93水平与ISR有关。介入术后14天血浆miR-93水平高提示LASO患者术后1年内发生ISR的风险高。
Aim To explore the predictive value of plasma microRNA-93(miR-93)level for in-stent restenosis(ISR)after interventional therapy in patients with lower extremity arteriosclerosis obliterans(LASO).Methods 184 patients with LASO admitted to the Affiliated Hospital of North China University of Technology from February 2016 to May 2019 were selected as the research objects.According to whether the patients with LASO had ISR within one year after intervention,they were divided into two groups:ISR group(n=71)and non-ISR group(n=113).Real-time fluorescence quantitative PCR was used to detect the plasma miR-93 level of LASO patients,and to explore the relationship between miR-93 and ISR.Results Comparing the plasma miR-93 levels between the ISR group and the non-ISR group,the differences between the two groups including time effect,inter-group effect,and time-to-group interaction effect were statistically significant(P<0.01).The area under the receiver operating characteristic curve,sensitivity,and specificity of postoperative 14 days miR-93 in diagnosing ISR were 0.839,91.55%,and 70.80%,respectively,and its diagnostic efficiency for ISR was higher than those of preoperative miR-93 and postoperative 7 days miR-93,the differences were statistically significant(P<0.001).Multivariate Logistic regression analysis showed that the length of vascular occlusion,postoperative 14 days miR-93,low density lipoprotein cholesterol and C-reactive protein were independent risk factors affecting ISR in LASO patients(P<0.01).Restricted cubic spline fitting Logistic regression analysis showed that miR-93 was related to ISR in LASO patients(P<0.001),and there was a non-linear relationship(P=0.009).Conclusion Plasma miR-93 level in LASO patients is related to ISR,and the high level of plasma miR-93 at 14 days after interventional surgery suggests that LASO patients have a high risk of ISR within one year after operation.
作者
徐永平
陈伟彬
陈俊卯
王长友
杨德久
XU Yongping;CHEN Weibin;CHEN Junmao;WANG Changyou;YANG Dejiu(Department of Medical Imaging,Affiliated Hospital of North China University of Technology,Tangshan,Hebei 063000,China;Department of General Surgery,Affiliated Hospital of North China University of Technology,Tangshan,Hebei 063000,China;Department of Interventional Medicine,Affiliated Hospital of North China University of Technology,Tangshan,Hebei 063000,China)
出处
《中国动脉硬化杂志》
CAS
2021年第8期702-706,712,共6页
Chinese Journal of Arteriosclerosis
基金
河北省医学科学研究课题(20191164)。
关键词
下肢动脉硬化闭塞症
微小RNA-93
介入术
支架内再狭窄
lower extremity arteriosclerosis obliterans
microRNA-93
interventional surgery
in-stent restenosis
