1. 断指再植患者术后血清MDA 、SOD、VEGF水平 变化与动脉血管危象发生的关系及其预测效能.
- Author
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石宇, 郑文, 赵玲珑, and 滕云升
- Abstract
Objective To observe the changes of serum malondialdehyde (MDA), superoxide dismutase (SOD) and vascular endothelial growth factor (VEGF) levels after replantation of severed finger, to clarify their relationships with the occurrence of arterial crisis in patients, and to further understand its effectiveness in predicting the occurrence of arterial crises. Methods Patients with early arterial crisis after replantation of severed finger (observation group) and patients without vascular crisis (control group) were selected. The levels of MDA, SOD and VEGF were compared between the two groups at different time (before surgery, 24 h after surgery, and when the arterial crisis was confirmed). Spearman correlation and multiple Logistic regression analysis were used to explore the correlations between serum MDA, SOD and VEGF levels and postoperative arterial crisis, and to evaluate the diagnostic efficacy of MDA, SOD and VEGF on postoperative arterial crisis at 24 h after replantation of severed finger. The relationships between serum levels of MDA, SOD and VEGF and the risk of arterial crisis after finger replantation was verified again by comparing the risk of arterial crisis in patients with different levels of MDA, SOD and VEGF. Results Compared with pre-operation, MDA and VEGF increased and SOD decreased in both groups at 24 h after operation and at the time of diagnosis of arterial crisis (all P<0. 05). Compared with 24 h after operation, MDA and VEGF decreased and SOD increased in both groups at the time of diagnosis of arterial crisis (all P<0. 05). Compared with the control group, the MDA was higher and the SOD and VEGF were lower in the ob‐ servation group at 24 h after operation (all P<0. 05). Spearman correlation analysis showed that serum MDA was positively correlated with arterial crisis after replantation of severed finger at 24 h after operation and at the time of diagnosis of arteri‐ al crisis (r=0. 859,0. 954, all P<0. 05); at 24 h after operation and at the time of diagnosis of arterial crisis, serum SOD and VEGF were negatively correlated with arterial crisis after replantation of severed finger (r=-0. 826,-0. 915,-0. 801, -0. 887, all P<0. 05), and serum MDA, SOD and VEGF at 24 h after operation were independent influencing factors of ar‐ terial crisis after replantation of severed finger (all P<0. 05). At 24 h after operation, the best diagnostic thresholds of MDA, SOD and VEGF in predicting arterial crisis were 8. 21,64. 35 and 126. 37 pg/mL, respectively, AUC was 0. 776, 0. 794 and 0. 714, respectively,95% CI was 0. 691–0. 847,0. 711–0. 863, and 0. 625–0. 793 respectively, their sensitivities were 72. 50%,85. 00% and 57. 50%, and specificities were 76. 25%,70. 00% and 76. 25%, respectively. The risk of arterial crisis in patients with high level of MDA (MDA≥8. 21 nmol/mL) was 6. 795 times that of patients with low level (MDA<8. 21 nmol/mL), the risk of arterial crisis in patients with high level of SOD (SOD≥64. 35 nmol/mL) was 0. 065 times that of patients with low level (SOD<64. 35 nmol/mL), and the risk of arterial crisis in patients with high lev‐ el of VEGF (VEGF≥126. 37 pg/mL) was 0. 189 times that of patients with low level (VEGF<126. 37 pg/mL)(all P< 0. 05). Conclusion The serum levels of MDA, SOD and VEGF after replantation of severed finger are related to the occurrence of arterial crisis, and the detection of MDA, SOD and VEGF at 24 h after the operation can predict the occurrence of arterial crisis after replantation of severed finger. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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