Page 61 - 南京医科大学自然版

第46卷第9期 南京医科大学学报（自然科学版）
2026年9月 Journal of Nanjing Medical University（Natural Sciences） ·1331 ·

·临床研究·

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

花 颖 ，葛佳俊 ，陈 浩 ，李晓飞 1*
1，2
1
1，2
南通大学附属医院心血管内科，江苏 南通 226001，南通大学医学院，江苏 南通 226001
1 2

［摘 要］ 目的：探讨血浆缺氧诱导因子⁃1α（hypoxia⁃inducible factor⁃1α，HIF⁃1α）与卵圆孔未闭（patent foramen ovale，PFO）合
并偏头痛患者经皮PFO封堵术后中到大量残余分流（moderate⁃to⁃large residual shunt，MLRS）的相关性。方法：前瞻性纳入2023年
8月—2024年8月于南通大学附属医院接受PFO封堵治疗的偏头痛患者45例，收集术前、术后6及12个月的临床资料，根据是
否发生 MLRS 分为 MLRS 组和非 MLRS 组，比较临床指标及血浆 HIF⁃1α水平。采用多因素 Logistic 回归筛选术后 6 及12个月
发生MLRS的潜在相关因素，受试者工作特征（receiver operating characteristic，ROC）曲线评估预测效能，并应用广义估算方程
（generalized estimating equation，GEE）分析 HIF⁃1α与抗凝血酶Ⅲ（antithrombin Ⅲ，AT⁃Ⅲ）和中性粒细胞计数比淋巴细胞计数
（neutrophil⁃to⁃lymphocyte ratio，NLR）的交互效应。结果：术后6及12个月血浆HIF⁃1α水平较术前下降（P < 0.01）。术后6及12个
月MLRS组术前HIF⁃1α均高于无MLRS组（P < 0.05）。多因素Logistic回归显示，术前HIF⁃1α水平是术后6及12个月MLRS的
共同潜在相关因素（P < 0.05）。术前AT⁃Ⅲ水平降低与术后6个月MLRS风险增加相关（P < 0.05），而术前NLR水平升高与术
后 12 个月 MLRS 风险增加相关（P < 0.05）。经 Bootstrap 校正后，术前 HIF⁃1α预测术后 6 及 12 个月 MLRS 的 ROC 曲线下面积
（area under curve，AUC）分别为0.823和0.825；联合AT⁃Ⅲ及联合NLR的AUC分别为0.953和0.937（P均<0.05）。GEE结果显示
HIF⁃1α与NLR存在显著关联（P < 0.05）。结论：PFO封堵术后HIF⁃1α水平呈持续下降。术前血浆HIF⁃1α可能是术后MLRS的
潜在相关因子，联合AT⁃Ⅲ或NLR分别对术后6及12个月的MLRS表现出初步的区分效能。
［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
［中图分类号］ R541.1 ［文献标志码］ A ［文章编号］ 1007⁃4368（2026）09⁃1331⁃10
doi：10.7655/NYDXBNSN260372

Correlation between HIF⁃1α and moderate⁃to⁃large residual shunt after closure in patients

with patent foramen ovale and migraine
1，2
1，2
1
HUA Ying ，GE Jiajun ，CHEN Hao ，LI Xiaofei 1*
2
1 Department of Cardiology，Affiliated Hospital of Nantong University，Nantong 226001；Medical College of Nantong
University，Nantong 226001，China
［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 antithrombin
Ⅲ（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

［基金项目］ 南通市自然科学基金和社会民生科技计划（MSZ2023182）；南通市卫生健康委员会科研课题（QNZ2023003）
通信作者（Corresponding author），E⁃mail：sofia_l@163.com（ORCID：0000⁃0001⁃6707⁃1274）
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