Diabetes Care:炎性细胞因子与下肢血管内血运重建术(LER)失败相关

2019-08-02 xing.T MedSci原创

由此可见,该研究证实基线时OPG、TNF-α、IL-6和CRP水平升高与正在接受血管内治疗的糖尿病、PAD和CLTI患者的血管结局恶化有关。

周围动脉疾病(PAD)是糖尿病最相关的并发症之一。虽然有几种药物和血运重建方法可用于治疗糖尿病和PAD患者,但血管内方法通常与术后并发症相关,后者可增加急性肢体缺血或截肢的风险。然而,目前尚无明确的分子关联机制可以解释糖尿病、PAD和慢性肢体威胁性缺血(CLTI)患者血管内治疗后结局的差异。 

近日,糖尿病领域权威杂志Diabetes Care上发表了一篇研究文章,研究人员评估了与糖尿病动脉粥样硬化相关的主要细胞因子水平与糖尿病、PAD和CLTI患者血管内手术后的结局之间的关系。

该研究共招募了299名接受血管成形术的膝关节以下闭塞性疾病患者。研究人员测量了关键细胞因子,包含骨保护素(OPG)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和C-反应蛋白(CRP)的水平,以及主要的不良肢体事件(MALE)并且在手术后1、3、6和12个月评估了主要的不良心血管事件(MACE)。在基线和MALE事件中,每种细胞因子从最低四分位数到最高四分位数之间存在线性趋势。每种细胞因子的增加水平与MACE事件之间也观察到了线性关联。通过使用临床和实验室危险因素构建受试者操作特征模型,并且纳入细胞因子可显著改善了事件的预测能力。

由此可见,该研究证实基线时OPG、TNF-α、IL-6和CRP水平升高与正在接受血管内治疗的糖尿病、PAD和CLTI患者的血管结局恶化有关。 

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