目的:改良的格拉斯哥预后评分(mGPS)是一种基于炎症的指标;它包括C反应蛋白升高和白蛋白含量降低的数据。在癌症等各种疾病中,研究了mGPS对结果的预测价值,心力衰竭,心肌梗塞,急性肺栓塞,和炎症性肠病。本研究旨在评估mGPS与外周动脉疾病(PAD)的严重程度和复杂性之间的联系,该联系由跨大西洋社区间共识文件(TASC-II)分类确定,以及mGPS对接受血管内治疗(EVT)患者手术成功的预测值。
方法:我们的研究包括203例连续接受EVT治疗的主髂动脉粥样硬化梗阻患者,股骨—————————————————————————————————————————————————————————————————————————————————————————————————以及2019年1月至2020年2月之间的膝盖以下动脉。根据TASC-II中的类别确定病变特征。手术失败是在经皮介入后无法将导丝定位通过闭塞病变或在EVT后无法实现远端灌注。
结果:在我们的研究中,我们观察到136例TASCA-B病变患者(%6)和67例TASCC-D病变患者(%33).在59.4%的患者中,对股骨—————————————————————————————————————————————————————————————————————————————————————————腹髂动脉占30.7%,膝关节以下动脉占9.9%。mGPS是严重PAD(OR:17.943,95%CI:5.120-62.882;p<.001)和手术成功(比值比:0.004;95%CI:0.001-0.099;p<.001)的独立预测因子。此外,我们确定年龄和TASCD病变的存在是介入成功的独立预测因素(OR:0.938,95%CI:0.819-0.979;p:.034;OR:0.104,95%CI:0.107-0.643;p:.015).
结论:我们确定mGPS根据TASC-II分类独立预测PAD的复杂性和严重程度;高mGPS患者的EVT成功率较低。
OBJECTIVE: The modified Glasgow Prognostic Score (mGPS) is one type of inflammation-based index; it includes data on elevated C-reactive protein and reduced albumin content. The predictive value of mGPS for outcomes is investigated in various diseases such as cancer, heart failure, myocardial infarction, acute pulmonary embolism, and inflammatory bowel diseases. This study aimed to evaluate the link between mGPS and the severity and complexity of peripheral arterial disease (PAD) as determined by the Transatlantic Intercommunal Consensus Document (TASC-II) classification and the prediction value of mGPS for procedural success in patients undergoing endovascular treatment (EVT).
METHODS: Our study included 203 consecutive patients receiving EVT for atherosclerotic obstruction of aortoiliac, femoro-popliteal, and below-knee arteries between January 2019 and February 2020. The lesion characteristics were determined according to categories in the TASC-II. Operational failure is the inability to position the guidewire through the occluded lesion following percutaneous intervention or achieve distal perfusion following EVT.
RESULTS: In our study, we observed 136 patients (%6) with TASC A-B lesions and 67 patients (%33) with TASC C-D lesions. EVT was performed on the femoro-popliteal artery in 59.4% of the patients, on the aortoiliac artery in 30.7%, and on the below-the-knee artery in 9.9%. mGPS was an independent predictor of severe PAD (OR: 17.943, 95% CI: 5.120-62.882; p < .001) and procedural success (odds ratio: 0.004; 95% CI: 0.001-0.099; p < .001). Additionally, we identified age and the presence of a TASC D lesion as independent predictors of interventional success (OR: 0.938, 95% CI: 0.819-0.979; p: .034; OR: 0.104, 95% CI: 0.107-0.643; p: .015, respectively).
CONCLUSIONS: We determined that mGPS independently predicts PAD complexity and severity based on TASC-II classification; the EVT success rate is lower in patients with high mGPS.