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雷诺病复发风险与手术方式之间的关联

Association Between Risk of Relapse and Type of Surgical Procedure for Raynaud's Disease.

作者信息

Zhi Tong, Xu Miao, Kuang Jiao, Wei Shirong, Yao Ming, Ni Huadong

机构信息

Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.

Department of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, China.

出版信息

Med Sci Monit. 2025 May 22;31:e947488. doi: 10.12659/MSM.947488.

Abstract

BACKGROUND Raynaud's syndrome, a vascular dysfunction disorder characterized by paroxysmal spasms of small arteries in the extremities, has long attracted attention in the medical field. Despite the absence of a comprehensive understanding of its etiology, this condition is considered to be associated with impaired vascular endothelial function, neuromodulation disorders, and genetic factors. MATERIAL AND METHODS We conducted an analysis of data from 110 eligible patients, with approval from the Ethics Committee of our hospital. We assessed medical records, the Visual Analog Scale (VAS), Pittsburgh Sleep Quality Index (PSQI), Disabilities of the Arm, Shoulder, and Hand (DASH) scores, and adverse events linked to relapse. Survival analyses were carried out using the Kaplan-Meier method. Univariate and multivariate analyses were employed to identify factors associated with RD and to construct a prognostic line chart for postoperative recurrence. RESULTS In the 6-month survival analysis model, the following factors demonstrated statistical significance in multivariate analysis: primary disease (HR: 1.718; 95% CI: 1.044-2.829), surgical approach (HR: 0.454; 95% CI: 0.272-0.760), perfusion index difference (HR: 0.870; 95% CI: 0.76-0.994), and peripheral temperature difference (HR: 0.755; 95% CI: 0.615-0.928). In the 1-year survival analysis model, statistically significant factors in multivariate analysis included primary disease (HR: 1.881; 95% CI: 1.125-3.145), surgical approach (HR: 0.489; 95% CI: 0.291-0.821), perfusion index difference (HR: 0.866; 95% CI: 0.759-0.989), and peripheral temperature difference (HR: 0.757; 95% CI: 0.618-0.928). CONCLUSIONS Independent risk factors for postoperative recurrence of Reynaud's syndrome include the primary disease, surgical approach, changes in perfusion indices, and changes in peripheral temperature.

摘要

背景

雷诺氏综合征是一种以四肢小动脉阵发性痉挛为特征的血管功能障碍性疾病,长期以来一直受到医学领域的关注。尽管对其病因尚无全面了解,但这种疾病被认为与血管内皮功能受损、神经调节紊乱和遗传因素有关。

材料与方法

在获得我院伦理委员会批准后,我们对110例符合条件的患者的数据进行了分析。我们评估了病历、视觉模拟量表(VAS)、匹兹堡睡眠质量指数(PSQI)、上肢、肩部和手部功能障碍(DASH)评分以及与复发相关的不良事件。使用Kaplan-Meier方法进行生存分析。采用单因素和多因素分析来确定与雷诺氏病相关的因素,并构建术后复发的预后线图。

结果

在6个月生存分析模型中,以下因素在多因素分析中具有统计学意义:原发性疾病(HR:1.718;95%CI:1.044-2.829)、手术方式(HR:0.454;95%CI:0.272-0.760)、灌注指数差异(HR:0.870;95%CI:0.76-0.994)和外周温度差异(HR:0.755;95%CI:0.615-0.928)。在1年生存分析模型中,多因素分析中具有统计学意义的因素包括原发性疾病(HR:1.881;95%CI:1.125-3.145)、手术方式(HR:0.489;95%CI:0.291-0.821)、灌注指数差异(HR:0.866;95%CI:0.759-0.989)和外周温度差异(HR:0.757;95%CI:0.618-0.928)。

结论

雷诺氏综合征术后复发的独立危险因素包括原发性疾病、手术方式、灌注指数变化和外周温度变化。

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