南京医科大学学报（自然科学版）2026，Vol.46Issue(9)：1331-1340,10.DOI:10.7655/NYDXBNSN260372
HIF-1α与卵圆孔未闭合并偏头痛患者封堵术后中到大量残余分流的相关性研究
Correlation between HIF-1α and moderate-to-large residual shunt after closure in patients with patent foramen ovale and migraine
摘要
Abstract
Objective:To investigate the association between plasma hypoxia-inducible factor-1α(HIF-1α)and moderate-to-large residual shunt(MLRS)after percutaneous patent foramen ovale(PFO)closure in patients with migraine and PFO.Methods:This prospective study included 45 migraine patients who underwent PFO closure at the Affiliated Hospital of Nantong University from August 2023 to August 2024.Patients were divided into MLRS and non-MLRS groups based on the presence or absence of MLRS.Clinical data and plasma HIF-1α levels were collected and compared before surgery,and 6 and 12 months after surgery.Multivariate logistic regression was used to identify potential factors for MLRS at 6 and 12 months.Receiver operating characteristic(ROC)curves evaluated predictive performance,and generalized estimating equation(GEE)assessed the interaction of HIF-1α with both antithrombinⅢ(AT-Ⅲ)and the neutrophil-to-lymphocyte ratio(NLR).Results:Plasma HIF-1α levels at 6 and 12 months postoperatively were significantly lower than preoperative levels(P＜0.01).Preoperative HIF-1α levels were significantly higher in the MLRS group than in the non-MLRS group at both follow-up time points(P＜0.05).Multivariate logistic regression showed that preoperative HIF-1α was a potential factor associated with MLRS at 6 and 12 months(P＜0.05).Decreased preoperative AT-Ⅲ levels were correlated with an increased risk of MLRS at 6 months postoperatively(P＜0.05),while elevated preoperative NLR levels were associated with an increased risk of MLRS at 12 months(P＜0.05).After Bootstrap correction,ROC analysis demonstrated that the area under curve(AUC)values of preoperative HIF-1α for predicting MLRS at 6 and 12 months were 0.823 and 0.825,respectively.The AUC for HIF-1α combined with AT-Ⅲ was 0.953(6 months),and with NLR was 0.937(12 months)(all P＜0.05).GEE revealed a significant association between HIF-1α and NLR(P＜0.05).Conclusion:Plasma HIF-1α levels show sustained decline after PFO closure.Preoperative plasma HIF-1α is a potential factor associated with postoperative MLRS,and its combination with AT-Ⅲ(at 6 months)and NLR(at 12 months)shows preliminary discriminative performance,respectively.关键词
卵圆孔未闭/偏头痛/缺氧诱导因子-1α/中到大量残余分流Key words
patent foramen ovale/migraine/hypoxia-inducible factor-1α/moderate-to-large residual shunt分类
医药卫生引用本文复制引用
花颖,葛佳俊,陈浩,李晓飞..HIF-1α与卵圆孔未闭合并偏头痛患者封堵术后中到大量残余分流的相关性研究[J].南京医科大学学报（自然科学版）,2026,46(9):1331-1340,10.基金项目
南通市自然科学基金和社会民生科技计划(MSZ2023182) （MSZ2023182）
南通市卫生健康委员会科研课题(QNZ2023003) （QNZ2023003）
