目的 探究循环中脂蛋白相关磷脂酶A2(Lp-PLA2)与stanford B型主动脉夹层支架置入术后不良事件的相关性。方法 回顾性分析2017-09至2021-05因Stanford B型夹层在陆军军医大学第二附属医院心血管内科住院并行胸腹主动脉腔内支架置入术的369例患者,分为康复组(332例)和不良事件组(37例),随访6个月,采集两组患者一般情况及血常规、肾功能、肝功能、C反应蛋白(CRP)和Lp-PLA2等指标,分析结局的独立影响因素,检验水准为0.05,探究循环中Lp-PLA2与支架术后的不良事件发生率之间的相关性。结果 不良事件组患者Lp-PLA2、白细胞计数(WBC)、CRP、尿酸(UA)均高于康复组,差异均具有统计学意义(P＜0.05)。进一步多因素分析显示,不良事件与Lp-PLA2(OR=1.024,95%CI:1.000～1.037)、WBC(OR=1.557,95%CI:1.189～2.671)、CRP(OR=1.005,95%CI:1.005～1.027)呈正相关。结论 Lp-PLA2的水平可能作为Stanford B型患者主动脉腔内血管修复术后不良事件的预测因子。
Abstract
Objective To investigate the correlations between Lp-PLA2 in circulation and the incidence of adverse events after Stanford type B aortic dissection with stent implantation. Methods The clinical data on 369 cases of Stanford type B aortic dissection with TEVAR treated between September 2017 and May 2021 was retrospectively analyzed. These patients were divided into the rehabilitation group (332 cases) and the adverse event group (37cases). The basic information, results of blood routine examination, indexes of renal function and liver function, and levels of CRP and Lp-PLA2 were collected and compared. The association between Lp-PLA2 and adverse events was analyzed. All the patients were followed up for 6 months. Independent sample t-test, non-parametric rank sum test, chi-square test or multivariate logistic regression analysis were used. SPSS22.0 software was used to analyze the independent influencing factors of the outcome. Results The levels of Lp-PLA2,WBC,CRP and UA in adverse event group were higher than those of the rehabilitation group (all P＜0.05).Multivariate logistic regression analysis showed that levels of Lp-PLA2, WBC and CRP were factors related to adverse events. Conclusions The expression of Lp-PLA2 is correlated with adverse events. Therefore, Lp-PLA2 may serve as a predictor of adverse events after thoracic endovascular aortic repair of Stanford type B aortic dissection.
关键词
脂蛋白相关磷脂酶A2 /
主动脉夹层 /
stanfordB型主动脉夹层 /
主动脉腔内血管修复术 /
炎性反应
Key words
lipoprotein-associated phospholipase A2 /
aortic dissection /
Stanford type B aortic dissection /
TEVAR /
inflammatory response
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