Predictive Value of Serum Intercellular Adhesion Molecule-1 Levels for Postoperative Restenosis in Patients with Lower Extremity Arteriosclerosis Obliterans

doi:10.3877/cma.j.issn.2095-5782.2026.01.004

Abstract

Abstract:

Objective

To analyze the predictive value of serum intercellular adhesion molecule-1 (ICAM-1) levels for postoperative restenosis in patients with lower extremity arteriosclerosis obliterans (ASO).

Methods

A total of 94 ASO patients admitted between July 2021 and July 2023 were enrolled. Based on the occurrence of restenosis within one year postoperatively, patients were divided into a restenosis group (n=37) and a patency group (n=57). Multivariate logistic regression and interaction analyses were used to evaluate the impact of ICAM-1 and other indicators on restenosis.

Results

Multivariate logistic regression analysis showed that infrapopliteal lesions, diabetes, hyperlipidemia, and elevated preoperative levels of C-reactive protein, interleukin-6, tumor necrosis factor-α, plasma viscosity, whole blood viscosity (high/low shear), and ICAM-1 were independent risk factors for postoperative restenosis (P<0.05). Interaction analysis revealed that preoperative ICAM-1 significantly interacted with endothelin and vascular endothelial growth factor to influence restenosis risk.

Conclusion

ICAM-1 levels are closely correlated with postoperative restenosis in ASO patients and serve as a significant predictor for the risk of re-obstruction.

Key words: Lower extremity arteriosclerosis obliterans, Serum intercellular cell adhesion molecule-1, Restenosis

Qin He, Xi Yong, Jingquan Chen. Predictive Value of Serum Intercellular Adhesion Molecule-1 Levels for Postoperative Restenosis in Patients with Lower Extremity Arteriosclerosis Obliterans[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2026, 14(01): 26-32.

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https://zhjrfsxdzzz.cma-cmc.com.cn/EN/Y2026/V14/I01/26

Figures/Tables 5

临床资料	再狭窄组(n=37)	通畅组(n=57)	t/χ²值	P值
男性[例(%)]	24(64.86)	29(50.88)	1.785	0.182
年龄(岁， $x ¯$ ±s)	69.96±7.87	67.14±7.21	1.787	0.077
Rutherford分级[例(%)]			0.888	0.346
Ⅰ~Ⅲ级	12(32.43)	24(42.11)
Ⅳ~Ⅵ级	25(67.57)	33(57.89)
病变部位[例(%)]			8.294	0.004
膝上血管	9(24.32)	31(54.39)
膝下血管	28(75.68)	26(45.61)
糖尿病[例(%)]	21(56.76)	18(31.58)	5.859	0.015
高血压[例(%)]	14(37.84)	12(21.05)	3.159	0.076
高脂血症[例(%)]	20(54.05)	14(24.56)	8.453	0.004
吸烟[例(%)]	24(64.86)	27(47.37)	2.767	0.096
饮酒[例(%)]	22(59.46)	25(43.86)	2.184	0.139
残余狭窄[例(%)]			3.757	0.053
＞20%	13(35.14)	10(17.54)
≤20%	24(64.86)	47(82.46)
介入治疗类型[例(%)]			3.147	0.076
经皮腔内血管成形术	18(45.95)	13(28.07)
经皮腔内血管成形术+支架植入术	19(54.05)	44(71.93)
术后药物使用[例(%)]
他汀类药物	17(45.95)	27(47.37)	0.018	0.893
抗凝药物	22(59.46)	30(52.63)	0.423	0.515
抗血小板药物	15(40.54)	16(28.07)	1.579	0.209

临床资料	再狭窄组(n=37)	通畅组(n=57)	t/χ²值	P值
男性[例(%)]	24(64.86)	29(50.88)	1.785	0.182
年龄(岁， $x ¯$ ±s)	69.96±7.87	67.14±7.21	1.787	0.077
Rutherford分级[例(%)]			0.888	0.346
Ⅰ~Ⅲ级	12(32.43)	24(42.11)
Ⅳ~Ⅵ级	25(67.57)	33(57.89)
病变部位[例(%)]			8.294	0.004
膝上血管	9(24.32)	31(54.39)
膝下血管	28(75.68)	26(45.61)
糖尿病[例(%)]	21(56.76)	18(31.58)	5.859	0.015
高血压[例(%)]	14(37.84)	12(21.05)	3.159	0.076
高脂血症[例(%)]	20(54.05)	14(24.56)	8.453	0.004
吸烟[例(%)]	24(64.86)	27(47.37)	2.767	0.096
饮酒[例(%)]	22(59.46)	25(43.86)	2.184	0.139
残余狭窄[例(%)]			3.757	0.053
＞20%	13(35.14)	10(17.54)
≤20%	24(64.86)	47(82.46)
介入治疗类型[例(%)]			3.147	0.076
经皮腔内血管成形术	18(45.95)	13(28.07)
经皮腔内血管成形术+支架植入术	19(54.05)	44(71.93)
术后药物使用[例(%)]
他汀类药物	17(45.95)	27(47.37)	0.018	0.893
抗凝药物	22(59.46)	30(52.63)	0.423	0.515
抗血小板药物	15(40.54)	16(28.07)	1.579	0.209

指标	时间效应		组间效应		交互效应
指标	F值	P值	F值	P值	F值	P值
CRP	251.809	<0.001	56.211	<0.001	42.431	<0.001
IL-6	373.462	<0.001	94.512	0.001	85.283	0.003
TNF-α	265.360	<0.001	43.272	0.003	41.509	0.005
血浆黏度	424.341	<0.001	119.673	<0.001	90.876	<0.001
全血黏度高切	181.745	<0.001	47.052	0.019	33.732	0.024
全血黏度低切	366.426	<0.001	83.426	<0.001	74.891	0.001
ET-1	401.807	<0.001	93.875	<0.001	98.055	<0.001
VEGF	316.822	<0.001	77.318	<0.001	65.424	<0.001
血清ICAM-1	439.457	<0.001	103.260	<0.001	99.716	<0.001

变量	OR(95% CI)	P值	容忍度	方差膨胀系数
病变部位	3.709(1.487~9.254)	0.005	0.304	3.288
糖尿病	2.844(1.207~6.702)	0.017	0.311	3.216
高脂血症	3.613(1.493~8.748)	0.004	0.427	2.341
术前CRP	6.000(1.565~23.007)	0.010	0.424	2.361
术前IL-6	5.556(1.673~18.449)	0.006	0.536	1.865
术前TNF-α	5.568(1.850~16.755)	0.003	0.448	2.231
术前血浆黏度	4.148(1.368~12.580)	0.014	0.467	2.141
术前全血黏度高切	5.677(1.612~19.987)	0.008	0.451	2.216
术前全血黏度低切	4.400(1.595~12.141)	0.005	0.598	1.673
术前血清ICAM-1	3.798(1.483~9.727)	0.007	0.336	2.981

	术前内皮指标水平	术前血清ICAM-1(ng/mL)	OR(95% CI)
ET-1(pg/mL)	≤75.11	≤366.94	1.000
	＞75.11	≤366.94	1.603(1.182~1.923)
	≤75.11	＞366.94	1.979(1.377~4.286)
	＞75.11	＞366.94	5.085(2.533~15.860)
ET-1交互作用			RERI=1.517(95% CI:-1.304~4.826), P>0.05
		相加模型	AP=0.504(95% CI: 0.132~0.968), P<0.05
			S=1.721(95% CI: 0.410~6.514), P>0.05
		相乘模型	OR=2.539(95% CI: 1.559~8.620), P<0.05
VEGF(pg/mL)	≤183.59	≤366.94	1.000
	＞183.59	≤366.94	3.122(1.651~14.469)
	≤183.59	＞366.94	2.239(0.885~6.376)
	＞183.59	＞366.94	6.324(2.026~19.351)
VEGF交互作用			RERI=2.011(95% CI:-2.158~8.037), P>0.05
		相加模型	AP=3.536(95% CI: 0.310~11.106), P<0.05
			S=5.109(95% CI: 0.592~20.234), P>0.05
		相乘模型	OR=6.227(95% CI: 2.586~25.927), P<0.05

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