| 彭怀玉,钟勇进,高雨蕉,等.下肢动脉硬化性闭塞症病人术前血清瘦素、艾帕素、内脏脂肪特异性丝氨酸蛋白酶抑制物水平与介入治疗后复发相关性[J].安徽医药,2023,27(3):461-465. |
| 下肢动脉硬化性闭塞症病人术前血清瘦素、艾帕素、内脏脂肪特异性丝氨酸蛋白酶抑制物水平与介入治疗后复发相关性 |
| Correlation between preoperative serum leptin, Apelin, Vaspin levels and recurrence after interventional therapy in patients with lower extremity arteriosclerosis obliterans |
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| DOI：10.3969/j.issn.1009-6469.2023.03.009 |
| 中文关键词: 闭塞性动脉硬化 下肢 瘦素 艾帕素 内脏脂肪特异性丝氨酸蛋白酶抑制物 介入治疗 复发 |
| 英文关键词: Arteriosclerosis obliterans Lower extremity Leptin Apelin Visceral adipose-specific serine protease inhibi-tor Interventional therapy Recurrence |
| 基金项目:陕西省自然科学基础研究计划项目(2019JM-571) |
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| 中文摘要: |
| 目的 探究血清瘦素、艾帕素(Apelin)、内脏脂肪特异性丝氨酸蛋白酶抑制物(Vaspin)水平对下肢动脉硬化性闭塞症(ASO)病人介入治疗后复发风险的预测价值。方法 选取2014年12月至2017年12月西安市第九医院收治的因ASO行介入治疗病人120例作为研究对象，根据术后复发情况分为复发组39例和无复发组81例。采用酶联免疫吸附测定检测病人术前血清瘦素、艾帕素、Vaspin水平；采用logistic回归模型分析ASO病人介入治疗后复发的影响因素；受试者操作特征曲线(ROC曲线)分析血清瘦素、艾帕素、Vaspin水平对ASO病人介入治疗后复发的预测价值。结果 复发组合并糖尿病比例、完全闭塞病变比例、单纯行球囊扩张术比例、血管病变长度显著高于无复发组(P<0.05)；复发组术前血清瘦素(9.48±2.03)μg/L水平显著高于无复发组(5.01±1.54)μg/L，血清艾帕素(1.19±0.34)μg/L、Vaspin(0.31±0.17)μg/L水平显著低于无复发组(1.76±0.62)μg/L、(0.43±0.12)μg/L(P<0.05)。与未合并糖尿病、血管病变长度<7.12 cm、无完全闭塞病变病人比较，合并糖尿病、血管病变长度≥7.12 cm、完全闭塞病变病人术前血清瘦素水平显著升高，血清艾帕素、Vaspin水平显著降低(P<0.05)。完全闭塞病变、瘦素是影响ASO病人介入治疗后复发的危险因素，艾帕素、Vaspin是影响ASO病人介入治疗后复发的保护因素(P<0.05)。血清瘦素、艾帕素、Vaspin联合检测对ASO病人介入治疗后复发预测的曲线下面积为0.87［95%CI:(0.80，0.94)］，灵敏度为89.70%，特异度为80.20%。结论 复发病人术前血清瘦素水平显著升高，血清艾帕素、Vaspin水平显著降低，与ASO病人介入治疗后复发密切相关，可能作为预测ASO病人预后的评估指标，且三者联合对ASO病人治疗后复发的预测价值最高。 |
| 英文摘要: |
| Objective To explore the predictive value of serum leptin, APJ endogenous ligand (Apelin) and visceral adipose-specif-ic serine protease inhibitor (Vaspin) levels on the recurrence risk after interventional therapy for patients with lower extremity arterio-sclerosis obliterans (ASO).Methods One hundred and twenty patients who received interventional therapy due to ASO in Xi'an Ninth Hospital from December 2014 to December 2017 were selected as the study objects. According to the postoperative recurrence, they were assigned into recurrence group (39 cases) and non recurrence group (81 cases). The serum leptin, Apelin and Vaspin levels before operation were detected by enzyme linked immunosorbent assay; logistic regression model was used to analyze the factors influencing the recurrence of ASO patients after interventional therapy; and receiver operating characteristic curve (ROC curve) was used to ana-lyze the predictive value of serum leptin, Apelin and Vaspin levels in relapse of ASO patients after interventional therapy.Results The proportion of patients with diabetes mellitus, complete occlusion, simple balloon dilatation, and length of vascular disease in the re-currence group were remarkable higher than those in the non recurrence group (P<0.05); the level of serum leptin (9.48±2.03) μg/L in the recurrence group was remarkable higher than that in the non recurrence group (5.01±1.54) μg/L, and the levels of serum Apelin(1.19±0.34) μg/L and Vaspin (0.31±0.17) μg/L were remarkable lower than those in the non recurrence group (1.76±0.62) μg/L and(0.43±0.12) μg/L (P<0.05). Compared with patients without diabetes mellitus, vascular lesion length < 7.12 cm and without complete occlusion, patients with diabetes mellitus, length of vascular disease ≥ 7.12 cm and total occlusion disease had significantly higher se-rum leptin level, and lower serum Apelin and Vaspin levels before operation (P<0.05). Total occlusion and leptin were the risk factors of recurrence in patients with ASO after interventional therapy, Apelin and Vaspin were the protective factors of recurrence in patients with ASO after interventional therapy (P<0.05). The area under the curve of the combined detection of serum leptin, Apelin and Vaspin in predicting the recurrence of ASO patients after intervention was 0.87 [95% CI: (0.80, 0.94)], with a sensitivity of 89.70% and a speci-ficity of 80.20%.Conclusions The level of serum leptin in patients with recurrence is remarkable increased before operation, the lev-els of serum Apelin and Vaspin are remarkable decreased. It is closely related to the recurrence of ASO patients after interventional therapy, it may be used as an evaluation index to predict the prognosis of ASO patients, and the combination of the three has the highest predictive value for the recurrence of ASO patients after treatment. |
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