Effect of vascular endothelial function on restenosis after carotid artery stenting
10.3969/j.issn.1673-9701.2024.19.009
- VernacularTitle:血管内皮功能对颈动脉支架植入术后再狭窄的影响
- Author:
Xiaoguang WANG
1
;
Fangyu YE
;
Jianhong TANG
Author Information
1. 金华市人民医院影像科,浙江金华 321000
- Keywords:
Carotid artery stenosis;
Carotid artery stenting;
Vascular endothelial function;
Inflammatory response;
Oxidative stress response
- From:
China Modern Doctor
2024;62(19):43-46,74
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of vascular endothelial function on restenosis after carotid artery stenting(CAS).Methods A total of 236 patients with carotid artery stenosis who received CAS in Jinhua People's Hospital from January 2019 to December 2022 were selected as study objects.According to whether in-stent restenosis(ISR)occurred during follow-up,they were divided into ISR group(n=41)and non-ISR group(n=195).Blood lipid indexes[low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C)],vascular endothelial indexes[endothelin-1(ET-1),von Willebrand factor(vWF),vascular endothelial growth factor(VEGF),vascular cell adhesion molecule 1(VCAM-1),thromboxane B2(TXB2),endothelial nitric oxide synthase(eNOS),nitric oxide(NO)],inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)]and oxidative stress indexes[malondialdehyde(MDA),glutathione peroxidase(GSH-Px),superoxide dismutase(SOD)]were collected and compared between two groups.Transcriptome sequencing was performed on peripheral blood of ISR group and non-ISR group.Multivariate Logistic regression was used to analyze the independent influencing factors of ISR after CAS.Results The levels of TC,TNF-α,CRP,IL-6,MDA,ET-1,vWF,TXB2 and VCAM-1 in ISR group were significantly higher than those in non-ISR group(P<0.01),and the levels of HDL-C,SOD,GSH-Px,NO,eNOS and VEGF in ISR group were significantly lower than those in non-ISR group(P<0.01).Transcriptome differential gene enrichment analysis showed that the signaling pathways such as inflammatory response activation,oxidative stress response,and endothelial cell dysfunction were significantly enhanced in ISR group.Multivariate Logistic regression analysis showed that TNF-α,IL-6,ET-1,vWF,VEGF,SOD,and GSH-Px were independent influencing factors for ISR after CAS(P<0.05).Conclusion Inflammatory factors,oxidative stress indexes and vascular endothelial function jointly promoted the occurrence and development of ISR after CAS in patients with carotid artery stenosis.TNF-α,IL-6,ET-1,vWF,VEGF,SOD,GSH-Px were independent risk factors for ISR after CAS.