动脉粥样硬化患者血清CML、血浆sCD40L水平与血管性眩晕相关性  

Correlation between serum CML and plasma sCD40L levels and vascular vertigo in patients with atherosclerosis

作　　者：邵良[1] 郭啸鸣[1] 曹志勇[1] 朱向阳[1] 李新玲[1] Shao Liang;Guo Xiaoming;Cao Zhiyong;Zhu Xiangyang;Li Xinling(Department of Neurology,the Second Affiliated Hospital of Nantong University,Jiangsu 226001,China)

机构地区：[1]南通大学第二附属医院神经内科,江苏226001

出　　处：《脑与神经疾病杂志》2022年第1期18-22,共5页Journal of Brain and Nervous Diseases

基　　金：江苏省卫生健康委科研项目(H2019057)。

摘　　要：目的观察动脉粥样硬化(AS)患者血清Nε-羧甲基赖氨酸(CML)、血浆可溶性CD40配体(sCD40L)水平变化与血管性眩晕发生的相关性。方法分析2015年1月-2019年12月南通大学第二附属医院接受治疗的54例AS合并血管性眩晕患者进行研究,按照1:1原则纳入同期本院接受治疗的54例AS未合并血管性眩晕患者进行研究,分别于治疗前、治疗3个月检测并比较两组血清CML水平、血浆sCD40L水平,分析血清CML、血浆sCD40L水平与血管性眩晕关系。结果AS合并血管性眩晕组治疗前、治疗3个月血清CML水平、血浆sCD40L水平及水平变化均高于AS未合并血管性眩晕组,差异有统计学意义(P<0.05)。多元Logistic回归分析显示:AS患者治疗前血清CML水平(OR=1.034,95%CI:1.009-1.060)、治疗3个月血清CML水平(OR=1.051,95%CI:1.021-1.081)、治疗3个月内血清CML水平变化(OR=1.333,95%CI:1.049-1.693)及治疗前血浆sCD40L水平(OR=1.025,95%CI:1.012-1.039)、治疗3个月血浆sCD40L水平(OR=1.040,95%CI:1.021-1.059)、治疗3个月内血浆sCD40L水平变化(OR=1.177,95%CI:1.079-1.284)均是血管性眩晕发生的影响因素(P<0.05)。绘制受试者工作曲线(ROC)发现,AS患者治疗3个月内血清CML及血浆sCD40L水平变化单项及联合预测血管性眩晕发生的曲线下面积(AUC)分别为0.815、0.807、0.876,均有一定预测价值(均>0.80),cut-off值分别取16.370 ng·mL;、22.790 pg·mL;时可以获得最佳预测效能。结论AS患者血清CML、血浆sCD40L水平变化与血管性眩晕发生存在密切联系,可将血清CML、血浆sCD40L水平变化作为血管性眩晕发生的预测指标。Objective To observe serum Nε-carboxymethyllysine(CML)and plasma soluble CD40 ligand(sCD40 L)levels in patients with atherosclerosis(AS),to analyze the correlation between changes in CML and sCD40 L levels and the occurrence of vascular vertigo.Methods To analyze 54 AS patients with vascular vertigo who were treated in the Second Affiliated Hospital of Nantong University from January 2015 to December 2019.According to the 1:1 principle,54 patients with AS without vascular vertigo who received treatment in this hospital during the same period were included in the study.Patients with vertigo were studied.The serum CML levels and plasma sCD40 L levels were measured and compared between the two groups before treatment and 3 months of treatment,and the relationship between serum CML and plasma sCD40 L levels and vascular vertigo was analyzed.Results The serum CML level,plasma sCD40 L level and the changes in the AS combined with vascular vertigo group before treatment and at 3 months of treatment were higher than those in the AS without vascular vertigo group,the difference was statistically significant(P<0.05).Multivariate Logistic regression analysis showed that:the serum CML level before treatment(OR=1.034,95%CI:1.009-1.060),the serum CML level after 3 months of treatment(OR=1.051,95%CI:1.021-1.081),the change of serum CML level within 3 months of treatment(OR=1.333,95%CI:1.049-1.693)and the plasma sCD40 L level before treatment(OR=1.025,95%CI:1.012-1.039),the plasma sCD40 L level at 3 months after treatment(OR=1.040,95%CI:1.021-1.059),the change of plasma sCD40 L level within 3 months after treatment(OR=1.177,95%CI:1.079-1.284)were the influencing factors of vascular vertigo(P<0.05).The receiver operating curve(ROC)was drawn:the area under curve(AUC)of the changes of serum CML and plasma sCD40 L levels in as patients within 3 months of treatment were0.815,0.807 and 0.876 respectively,which had certain predictive value(all>0.80).The best predictive effect could be obtained when the cut-off value was 16.370 ng·mL;

关 键 词：动脉粥样硬化 血管性眩晕 Nε-羧甲基赖氨酸 可溶性CD40配体 

分 类 号：R743.32[医药卫生—神经病学与精神病学]