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内脂素:冠状动脉搭桥术后隐静脉移植物病变晚期预测的新标志物。

Adropin: a new marker for predicting late saphenous vein graft disease after coronary artery bypass grafting.

作者信息

Demircelik Bora, Cakmak Muzaffer, Nazli Yunus, Gurel Ozgul M, Akkaya Nermin, Cetin Mustafa, Cetin Zehra, Selcoki Yusuf, Kurtul Alparslan, Eryonucu Beyhan

出版信息

Clin Invest Med. 2014 Oct 4;37(5):E338-44. doi: 10.25011/cim.v37i5.22014.

DOI:10.25011/cim.v37i5.22014
PMID:25282140
Abstract

PURPOSE

Saphenous vein graft disease (SVGD), defined as an occlusion of 50% or more of the SVG excluding distal anastomotic occlusion, is an important predictor of morbidity after coronary artery bypass grafting (CABG). Late graft occlusion is a serious complication that often limits the use of the saphenous vein as a coronary bypass graft. Late graft occlusion is particularly common in old, degenerated venous grafts with advanced atherosclerotic plaques. Adropin has been implicated in the homeostatic control of metabolism. The purpose of this study was to investigate whether serum adropin levels are associated with late SVGD following CABG.

METHODS

Thirty-eight patients with SVGD involving at least one graft (occluded group; 14 females, 24 males) and 42 patients with a patent saphenous vein graft (patent group; 15 females, 27 males) were enrolled in this study. Venous blood samples were taken from all of the participants to measure plasma adropin levels using an enzyme-linked immunsorbent assay kit.

RESULTS

The mean adropin level was significantly lower in the occluded group than in the patent group (3.2 ± 0.71 vs. 4.9 ± 1.51 ng/mL, p < 0.001). Multivariate regression analysis showed that the adropin level was the independent predictor of late saphenous vein graft occlusion.

CONCLUSIONS

Adropin levels are lower in patients with late saphenous vein graft occlusion and these reduced adropin levels, together with other factors, may lead to saphenous vein graft occlusion. Larger and prospective studies are needed to determine if adropin plays a role in the pathogenesis of SVGD.

摘要

目的

隐静脉移植血管病变(SVGD)定义为不包括远端吻合口闭塞在内的隐静脉移植血管闭塞50%或以上,是冠状动脉旁路移植术(CABG)后发病的重要预测指标。晚期移植血管闭塞是一种严重并发症,常限制隐静脉作为冠状动脉旁路移植血管的应用。晚期移植血管闭塞在伴有晚期动脉粥样硬化斑块的陈旧、退化静脉移植血管中尤为常见。内脂素与代谢的稳态控制有关。本研究的目的是探讨血清内脂素水平是否与CABG术后晚期SVGD相关。

方法

本研究纳入了38例至少有一根移植血管发生SVGD的患者(闭塞组;14例女性,24例男性)和42例隐静脉移植血管通畅的患者(通畅组;15例女性,27例男性)。采集所有参与者的静脉血样,使用酶联免疫吸附测定试剂盒测量血浆内脂素水平。

结果

闭塞组的平均内脂素水平显著低于通畅组(3.2±0.71对4.9±1.51 ng/mL,p<0.001)。多变量回归分析显示,内脂素水平是晚期隐静脉移植血管闭塞的独立预测指标。

结论

晚期隐静脉移植血管闭塞患者的内脂素水平较低,这些降低的内脂素水平与其他因素一起可能导致隐静脉移植血管闭塞。需要开展更大规模的前瞻性研究来确定内脂素是否在SVGD的发病机制中起作用。

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