Objective: To investigate the study of the correlation between C-reactive protein to albumin ratio (CAR) and restenosis after stenting in patients with lower extremity atherosclerotic occlusive disease(LEASO). Methods: The clinical data of 95 patients with LEASO admitted to the Department of Vascular Surgery of Nanjing Drum Tower Hospital from June 2020 to December 2022 were retrospectively analyzed. There were 67 males and 28 females,aged (73.1±9.4) years (range:51 to 92 years). The patients were classified into the restenosis group (n=61) and the patency group (n=34) according to the CT angiography results. Independent sample t test,Mann-Whitney U test and χ2 test were used to compare the data between two groups. Risk factors for restenosis after femoropopliteal artery stenting in patients with LEASO were analyzed using multivariate Cox regression. The relationship between preoperative CAR level and restenosis after stent placement was analyzed. Subject operating characteristic(ROC) curves of CAR were plotted to assess the predictive value of CAR for restenosis after stenting,and the results were expressed as area under the curve (AUC). Results: The aortoiliac calcification grade,number of stents,length of stents,C-reactive protein and CAR levels in restenosis group were higher than those in the patency group,and the serum albumin level was lower than that in the patency group(all P<0.05). And the results of multifactorial Cox regression analysis showed that higher pre-procedure CAR level and lower ABI value was an independent risk factor for in-stent restenosis. The AUC of the ROC curve for restenosis was 0.737(95%CI:0.617 to 0.856),the AUC of the ROC curve for 12-month restenosis was 0.709(95%CI:0.602 to 0.815), and the AUC of the ROC curve for 24-month restenosis was 0.702(95%CI:0.594 to 0.811). Conclusion: Higher pre-procedural CAR levels in patients with LEASO is risk factor for in-stent restenosis,and CAR has a predictive value for restenosis after lower extremity arterial stent dilatation and angioplasty.
目的： 探讨炎症指标C反应蛋白与白蛋白的比值（CAR）与下肢动脉硬化闭塞症（LEASO）行股腘支架置入术后再狭窄的相关性。 方法： 回顾性收集2020年6月至2022年12月南京大学医学院附属鼓楼医院血管外科收治的95例LEASO患者的临床资料。男性67例，女性28例，年龄（73.1±9.4）岁（范围：51~92岁）。根据复查的CT血管造影结果判断是否发生支架内再狭窄，将患者分为再狭窄组（n=61）和通畅组（n=34）。采用独立样本t检验、Mann-Whitney U检验、χ2检验对两组患者的一般资料、术前检查结果和手术情况等进行比较，采用多因素Cox回归分析LEASO患者行股腘动脉支架术后再狭窄的危险因素。绘制CAR的受试者工作特征曲线，计算曲线下面积（AUC），评估CAR对支架术后再狭窄的预测价值。 结果： 与通畅组相比，支架内再狭窄组患者主髂钙化分级、支架数量、支架长度、C反应蛋白、CAR水平均高于通畅组，血清白蛋白水平低于通畅组，差异有统计学意义（P值均<0.05）。多因素Cox回归分析结果显示，术前CAR水平较高与踝肱指数较低是支架内再狭窄的独立危险因素。CAR预测支架置入术后6个月再狭窄的AUC为0.737（95%CI：0.617~0.856），预测术后12个月再狭窄的AUC为0.709（95%CI：0.602~0.815），预测术后24个月再狭窄的AUC为0.702（95%CI：0.594~0.811）。 结论： 下肢动脉硬化闭塞症患者术前较高CAR水平是支架内再狭窄的独立危险因素，CAR对下肢动脉支架扩张成形术后再狭窄具有一定的预测价值。.