股腘动脉搭桥术后股腘动脉段闭塞狭窄病变患者再狭窄的免疫状况

V. Lazarenko, E. A. Bobrovskaya, I. S. Ivanov, V. Lipatov, V. Mishustin, Elizaveta I. Godunova
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In patients with the development of restenosis of the reconstruction zone, the level of IgA in the systemic and IgA, IgM in the local bloodstream was initially lower, the level of CIC, IL-1, IL-6 in the systemic and IgG, IL-1, IL-6 in the local bloodstream was higher, after surgery, the level of IgA in the local bloodstream was lower, higher - IgM in systemic and IL-6 in local blood flow in comparison with patients without restenosis. The correlation between the immune status and the development of restenosis was established: before surgery in the systemic circulation - IgA (r=-0.31, p<0.01), CIC (r=0.39, p<0.001), IL-6 (r=0.25, p<0.05), IL-1 (r=0.26, p<0.05), in the local bloodstream - IgA (r=-0.26, p<0.05), IgM (r=-0.30, p<0.01), IgG (r=0.26, p<0.05), IL-6 (r=0.30, p<0.01), IL-1 (r=0.29, p<0.01); after surgery in the systemic circulation - IgM (r=0.33, p<0.01), in the local - IgA (r=-0.24, p<0.05), IL-6 (r=0.40, p<0.001). 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引用次数: 0

摘要

目的:评价合并和不合并股腘动脉搭桥术后全身和局部血流的免疫状况。材料和方法。本文对82例股骨-腘动脉搭桥手术患者的治疗进行了分析。根据12个月后重建区的情况将患者分为两组:I组- 21例无再狭窄,II组- 61例发生再狭窄。分析手术前后全身及局部血流中IgA、IgM、IgG、循环免疫复合物(CIC)、白细胞介素(IL)-6、IL-1水平。结果。重建区发生再狭窄的患者,与未发生再狭窄的患者相比,局部血流中IgA、IgA、IgM水平初始较低,全身CIC、IL-1、IL-6水平和局部血流中IgG、IL-1、IL-6水平较高,术后局部血流中IgA水平较低,全身IgM和局部血流中IL-6水平较高。免疫状态与再狭窄发生的相关性:术前体循环中IgA (r=-0.31, p<0.01)、CIC (r=0.39, p<0.001)、IL-6 (r=0.25, p<0.05)、IL-1 (r=0.26, p<0.05),局部血流中IgA (r=-0.26, p<0.05)、IgM (r=-0.30, p<0.01)、IgG (r=0.26, p<0.05)、IL-6 (r=0.30, p<0.01)、IL-1 (r=0.29, p<0.01);术后体循环中- IgM (r=0.33, p<0.01)、局部- IgA (r=-0.24, p<0.05)、IL-6 (r=0.40, p<0.001)。观察慢性动脉功能不全程度(r=0.22, p<0.05)、术后踝肱指数(r=-0.27, p<0.05)与再狭窄发生的关系。结论。研究表明,术前、术后全身及局部血流免疫状态与股骨-腘动脉搭桥术后吻合区再狭窄的关系。对免疫状态的研究将使开发一种预防再狭窄的算法成为可能。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Immune status in developing restenosis in patients with occlusive-stenotic lesion of the femoral-popliteal arterial segment after femoral-popliteal bypass surgery
Objective: to assess the immune status of systemic and local blood flow after femoral-popliteal bypass surgery in patients with and without restenosis. Materials and methods. The analysis of the treatment of 82 patients who underwent femoral-popliteal bypass surgery was carried out. Depending on the condition of the reconstruction zone after 12 months, the patients were divided into two groups: group I - 21 patients without restenosis, group II - 61 patients with the development of restenosis. The analysis of IgA, IgM, IgG, circulating immune complexes (CIC), interleukin (IL)-6, IL-1 in the systemic and local blood flow before and after surgery was performed. Results. In patients with the development of restenosis of the reconstruction zone, the level of IgA in the systemic and IgA, IgM in the local bloodstream was initially lower, the level of CIC, IL-1, IL-6 in the systemic and IgG, IL-1, IL-6 in the local bloodstream was higher, after surgery, the level of IgA in the local bloodstream was lower, higher - IgM in systemic and IL-6 in local blood flow in comparison with patients without restenosis. The correlation between the immune status and the development of restenosis was established: before surgery in the systemic circulation - IgA (r=-0.31, p<0.01), CIC (r=0.39, p<0.001), IL-6 (r=0.25, p<0.05), IL-1 (r=0.26, p<0.05), in the local bloodstream - IgA (r=-0.26, p<0.05), IgM (r=-0.30, p<0.01), IgG (r=0.26, p<0.05), IL-6 (r=0.30, p<0.01), IL-1 (r=0.29, p<0.01); after surgery in the systemic circulation - IgM (r=0.33, p<0.01), in the local - IgA (r=-0.24, p<0.05), IL-6 (r=0.40, p<0.001). The relationship between the degree of chronic arterial insufficiency (r=0.22, p<0.05), the ankle- brachial index after surgery (r=-0.27, p<0.05) with the development of restenosis was revealed. Conclusion. The interrelation of the immune status of the systemic and local blood flow before and after surgery and restenosis in the anastomosis zone after femur-popliteal bypass surgery has been shown. The study of the immune status will make it possible to develop an algorithm for restenosis prevention.
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