血管生成素样蛋白2在下肢动脉粥样硬化闭塞症血浆中的变化及其意义  

Change of Serum Angiopoietin-like Protein 2 and Its Significance in Patients with Arteriosclerotic Occlusion

作　　者：梁越[1,2] 聂皓[1] 任华亮[3] 李方达[1] 田翠[4] 李汇华[5,6] 郑月宏[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院血管外科,北京100730 [2]内蒙古自治区人民医院血管外科,内蒙古010017 [3]首都医科大学附属北京朝阳医院血管外科,北京100020 [4]首都医科大学生理学与病理生理学系,北京100069 [5]大连医科大学附属第一医院心血管病研究所心内科,辽宁大连116011 [6]大连医科大学公共卫生学院慢性非传染性疾病预防控制中心,辽宁大连116044

出　　处：《中国医学科学院学报》2017年第2期188-195,共8页Acta Academiae Medicinae Sinicae

基　　金：国家自然科学基金(81270390)~~

摘　　要：目的探讨血管生成素样蛋白2(Angptl2)在下肢动脉粥样硬化闭塞症患者血浆中的水平,以及其在下肢动脉粥样硬化闭塞症不同阶段的变化及其意义。方法分析75例下肢动脉粥样硬化闭塞症患者(病例组)及65例健康体检者(对照组)血浆Angptl2水平。常规检测血生化指标及超敏C反应蛋白,采用酶联免疫分析法测定血浆Angptl2、脂联素水平。结果下肢动脉粥样硬化闭塞症患者血浆Angptl2水平较健康对照显著升高[(13.55±9.17)μg/L比(9.04±4.79)μg/L,P=0.010]。糖尿病人群中,下肢动脉粥样硬化闭塞症患者的血浆Angptl2水平(18.67±9.84)μg/L较对照组(13.01±3.47)μg/L升高(P=0.021)。在重症下肢缺血组Angptl2水平较间歇性跛行组更高[(17.01±10.20)μg/L比(10.53±6.97)μg/L,P=0.003]。Angptl2>13.67μg/L诊断效果最好,敏感性为60.34%,特异性为81.25%。在病例组中,血浆Angptl2水平与踝-肱指数呈负相关(斯皮尔曼相关系数=-0.244,P=0.035)。结论下肢动脉粥样硬化闭塞症患者的血浆Angptl2水平升高。当疾病进展为重症下肢缺血时,Angptl2水平的升高更为明显,可以作为判断疾病进展程度的潜在生物学标志物。Objective To investigated the changes of angiopoietin-like protein 2（ Angptl2） in patients with arteriosclerotic occlusion（ ASO）. Methods A total of 140 subjects including 75 ASO patients（ ASO group） and 65 healthy subjects（ control group） were enrolled in this study. Angptl2 and adiponectin were evaluated by using enzyme-linked immunosorbent assay. Biochemical data and high sensitive C reactive protein were measured and recorded as well. Results Compared to the control group, the ASO group presented with significantly higher level of plasma Angptl2 [（ 13. 55 ± 9. 17） μg/L vs.（ 9. 04 ±4. 79） μg/L, P = 0. 010]. Plasma Angptl2 level of critical limb ischemia subjects was significantly higher than that of intermittent claudication subjects [（ 17. 01 ± 10. 20） μg/L vs.（ 10. 53 ± 6. 97） μg/L,P = 0. 003]. The best diagnostic cutoff value of Angptl2 was 13. 67 μg/L, with a sensitivity of 60. 34 %and a specificity of 81. 25 %. In addition, type 2 diabetes mellitus patients with ASO exhibited significantly higher serum Angptl2 levels [（ 18. 67 ± 9. 84） μg/L] than those without ASO [（ 13. 01 ± 3. 47） μg/L]（ P = 0. 021）. In ASO group,serum Angptl2 levels were negatively correlated with ankle brachial index（ r =-0. 244,P = 0. 035）. Conclusions The plasma level of Angptl2 increases in ASO patients. Its level is remarkably increased when the disease progressions to critical limb ischemia. Angptl2 can be a potential biological marker of disease progression.

关 键 词：下肢动脉粥样硬化闭塞症 血管生成素样蛋白2 间歇性跛行 重症下肢缺血 诊断 临床意义 

分 类 号：R654.4[医药卫生—外科学]