血清FGF21、ANXA1、KLF2水平与下肢动脉硬化闭塞症患者支架植入术后1年内发生支架内再狭窄的关系OA

Objective To investigate the relationship between serum fibroblast growth factor 21(FGF21),annexin A1(ANXA1)and Krüppel-like transcription factor(KLF)2 levels and in-stent restenosis(ISR)within 1 year after stent implantation in patients with lower extremity arteriosclerosis obliterans(LEASO).Methods A total of 183 LEASO patients admitted to the hospital from August 2021 to August 2024 were se-lected as the research objects.All patients received stent implantation.Multivariate Logistic regression was used to analyze the influencing factors of ISR within 1 year after stent implantation in LEASO patients.The receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of serum FGF21,ANXA1 and KLF2 alone and in combination for ISR within 1 year after stent implantation in LEASO pa-tients.The calibration curve and Hosmer-Lemeshow test combined decision analysis curve were used for inter-nal validation and clinical applicability analysis of the combined prediction model.Results The levels of serum FGF21 and ANXA1,as well as the proportions of patients with smoking history,hypertension and diabetes in the ISR group were all higher than those in the N-ISR group,while the level of serum KLF2 in the ISR group was lower than that in the N-ISR group,and the differences were statistically significant(P<0.05).Multiva-riate Logistic regression analysis showed that smoking history,diabetes,and elevated serum FGF21 and ANXA1 levels were risk factors for ISR within 1 year after stent implantation in LEASO patients(P<0.05).Increased serum KLF2 level was a protective factor for ISR within 1 year after stent implantation in LEASO patients(P<0.05).The results of ROC curve analysis showed that the area under the curve(AUC)of serum FGF21,ANXA1 and KLF2 combined to predict ISR within 1 year after stent implantation in LEASO patients was 0.918,which was greater than the AUC of serum FGF21,ANXA1 and KLF2 alone(Zcombined-FGF21=2.650;Pcombined-FGF21=0.008;Zcombination-ANXA1=2.856,Pcombination-ANXA1=0.004;Zcombination-KLF2=3.223,Pcombination-KLF2=0.001).The calibration curve of the combined prediction model was in good agreement with the ideal curve(Hosmer-Lemeshow test χ2=6.315,P=0.612).Within the high-risk threshold of 0.08-0.96,the net bene-fit rate of serum FGF21,ANXA1 and KLF2 combined model in predicting ISR within 1 year after stent im-plantation in LEASO patients was better than that of the single index.Conclusion The serum levels of FGF21,ANXA1 and KLF2 are related to the occurrence of ISR within 1 year after stent implantation in LEASO patients,and they have certain predictive value and clinical applicability for ISR in LEASO patients af-ter stent implantation.