Guo Songlin, Zhang Zhang, Wang Lei, Yuan Liangxi, Bao Junmin, Zhou Jian, Jing Zaiping
Department of General Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
Department of Vascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
Vascular. 2020 Dec;28(6):715-721. doi: 10.1177/1708538120921005. Epub 2020 May 14.
To determine the association of pre- and postinterventional serum levels of interleukin-6 and high-sensitivity C-reactive protein at the six-month evaluation of restenosis after stenting of the femoropopliteal artery.
Sixty-eight consecutive patients with steno-occlusive femoropopliteal artery disease of Rutherford category III or IV who underwent stent implantation were included. Six-month patency was evaluated with color-coded duplex ultrasound. The association of in-stent restenosis with interleukin-6 and high-sensitivity C-reactive protein levels at baseline, and 24-h postintervention was assessed with a multivariate logistic regression analysis.
In-stent restenosis was found in 15 patients (22.1%) within six months. Interleukin-6 and high-sensitivity C-reactive protein levels were significantly increased at 24-h postintervention compared to their preintervention values ( < 0.001 and = 0.002, respectively). Interleukin-6 values at baseline (odds ratio, 1.11; 95% confidence interval: 1.00, 1.23; = 0.044) and 24-h postintervention (odds ratio, 1.04; 95% confidence interval: 1.02, 1.06; < 0.001) were independently associated with six-month in-stent restenosis. Twenty-four-hour postinterventional high-sensitivity C-reactive protein levels were also found to be related to restenosis (odds ratio, 1.15; 95% confidence interval: 1.04, 1.26; = 0.006), but high-sensitivity C-reactive protein levels at baseline did not show an independent association with in-stent restenosis (odds ratio, 0.57; 95% confidence interval: 0.35, 1.80; = 0.667). Smoking, diabetes mellitus, and cumulative stent length were other parameters associated with an increased risk for in-stent restenosis.
Femoropopliteal artery angioplasty with stent placement induces an inflammatory response. Interleukin-6 is a powerful independent predictor of intermediate-term outcomes for stenting of the femoropopliteal artery, suggesting that its predictive value may be superior to that of high-sensitivity C-reactive protein.
在股腘动脉支架置入术后6个月再狭窄评估中，确定介入前后血清白细胞介素-6和高敏C反应蛋白水平之间的关联。
纳入68例连续接受支架植入术的卢瑟福III或IV级股腘动脉狭窄闭塞性疾病患者。采用彩色编码双功超声评估6个月通畅情况。通过多因素逻辑回归分析评估支架内再狭窄与基线及介入后24小时白细胞介素-6和高敏C反应蛋白水平之间的关联。
15例患者（22.1%）在6个月内出现支架内再狭窄。与介入前相比，介入后24小时白细胞介素-6和高敏C反应蛋白水平显著升高（分别为<0.001和=0.002）。基线时白细胞介素-6值（比值比，1.11；95%置信区间：1.00，1.23；=0.044）和介入后24小时白细胞介素-6值（比值比，1.04；95%置信区间：1.02，1.06；<0.001）与6个月支架内再狭窄独立相关。还发现介入后24小时高敏C反应蛋白水平与再狭窄有关（比值比，1.15；95%置信区间：1.04，1.26；=0.006），但基线时高敏C反应蛋白水平与支架内再狭窄无独立关联（比值比，0.57；95%置信区间：0.35，1.80；=0.667）。吸烟、糖尿病和累计支架长度是与支架内再狭窄风险增加相关的其他参数。
股腘动脉血管成形术加支架置入会引发炎症反应。白细胞介素-6是股腘动脉支架置入中期结局的有力独立预测指标，表明其预测价值可能优于高敏C反应蛋白。
