Gou Wei, Wang Xu, Wang Lei, Wang Kehua, Chen Shan
Department of Vascular Surgery, Cardiovascular and Cerebrovascular Disease Hospital, General Hospital of Ningxia Medical University Yinchuan 750002, Ningxia, China.
Departement of Hyperbaric Oxygen, People's Hospital of Ningxia Hui Autonomous Region Yinchuan 750002, Ningxia, China.
Am J Transl Res. 2023 Feb 15;15(2):1186-1194. eCollection 2023.
To explore the correlation of tumor necrosis factor α (TNF-α), cystatin C (Cys C), and NLR family pyrin domain containing 3 (NLRP3) inflammasomes with venous ulcers from lower extremity varicose veins.
In this retrospective analysis, 135 patients with primary varicose veins of lower extremities were selected and divided into a varicose ulcer group (n=32) and a non-varicose ulcer group (n=103) according to clinical ulcer presence. Healthy adults with similar general information during the same period were included as a healthy controls (n=30). The levels of TNF-α, interleukin-1β (IL-1β), Cys C, and NLRP3 inflammasomes were statistically analyzed among the three groups. Logistic regression was used for analyzing the risk factors for venous ulcers in patients with varicose veins of the lower extremities. Spearman correlation was applied for correlation analysis. The area under the receiver operating characteristic (ROC) curve (AUC) was found to disclose the predictive value of TNF-α, Cys C, and NLRP3 inflammasomes for venous ulcers.
(1) Logistic regression analysis showed that TNF-α, IL-1β, and NLRP3 inflammasomes were risk factors for venous ulcers in patients with varicose veins of the lower extremity, and Cys C in ulcer wound tissue was a protective factor. (2) TNF-α was significantly correlated with IL-1β and Cys C in ulcer wound tissue, and NLRP3 in plasma (r=0.256, -0.290, 0.305; =0.003, 0.001, <0.001). IL-1β was significantly correlated with CysC in ulcer wound tissue and plasma (r=-0.251, -0.193; =0.003, 0.025). (3) The AUC, sensitivity, and specificity of TNF-α and NLRP3 inflammasomes for predicting varicose veins were high, with AUC of 0.881 and 0.712, sensitivity of 0.875% and 0.875%, and specificity of 0.893% and 0.738%, respectively.
TNF-α in plasma, Cys C in ulcer wound tissue and plasma, and NLRP3 inflammasomes in plasma were closely related to the occurrence of venous ulcers in patients with varicose veins of the lower and may serve as new targets for treatment.
探讨肿瘤坏死因子α（TNF-α）、胱抑素C（Cys C）和含NLR家族pyrin结构域3（NLRP3）炎性小体与下肢静脉曲张性静脉溃疡的相关性。
本回顾性分析选取135例原发性下肢静脉曲张患者，根据临床是否存在溃疡分为曲张溃疡组（n = 32）和非曲张溃疡组（n = 103）。同期选取一般资料相似的健康成年人作为健康对照组（n = 30）。对三组患者的TNF-α、白细胞介素-1β（IL-1β）、Cys C和NLRP3炎性小体水平进行统计学分析。采用Logistic回归分析下肢静脉曲张患者发生静脉溃疡的危险因素。采用Spearman相关性分析进行相关性分析。通过绘制受试者工作特征（ROC）曲线下面积（AUC）来揭示TNF-α、Cys C和NLRP3炎性小体对静脉溃疡的预测价值。
（1）Logistic回归分析显示，TNF-α、IL-1β和NLRP3炎性小体是下肢静脉曲张患者发生静脉溃疡的危险因素，溃疡创面组织中的Cys C是保护因素。（2）溃疡创面组织中的TNF-α与IL-1β、Cys C以及血浆中的NLRP3显著相关（r = 0.256，-0.290，0.305；P = 0.003，0.001，<0.001）。IL-1β与溃疡创面组织及血浆中的CysC显著相关（r = -0.251，-0.193；P = 0.003，0.025）。（3）TNF-α和NLRP3炎性小体预测静脉曲张的AUC、敏感性和特异性较高，AUC分别为0.881和0.712，敏感性分别为0.875%和0.875%，特异性分别为0.893%和0.738%。
血浆中的TNF-α、溃疡创面组织及血浆中的Cys C以及血浆中的NLRP3炎性小体与下肢静脉曲张患者静脉溃疡的发生密切相关，可能成为新的治疗靶点。
