老年患者血浆氧化三甲胺水平与颈动脉斑块负荷的关系研究  

Relationship between plasma trimethylamine N-oxide and carotid artery plaque burden in elderly patients

作　　者：熊筱伟 穆利英[1] 付强[1] 徐晓薇[1] 胡宏宇[1] 陈威[1] 陈步星 Xiong Xiaowei;Mu Liying;Fu Qiang;Xu Xiaowei;Hu Hongyu;Chen Wei;Chen Buxing(Department of Cardiology,Affiliated Beijing Tiantan Hospital of Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院心脏中心,100070 [2]北京中医药大学第三附属医院心血管科

出　　处：《中华老年心脑血管病杂志》2022年第6期568-570,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(81770349)。

摘　　要：目的分析老年患者血浆氧化三甲胺(TMAO)水平与颈动脉斑块负荷的关系。方法入选2013年1月~2016年12月首都医科大学附属北京天坛医院就诊的可疑心脑血管疾病的老年患者79例,根据颈动脉斑块是否形成富脂质坏死脂核(LRNC)分为无LRNC组23例和LRNC组56例。应用高效液相色谱法测血浆TMAO水平,进行MRI检查,计算颈动脉斑块的LRNC大小和总管壁体积(TWV),用多因素logistic回归分析和相关性分析。结果与无LRNC组比较,LRNC组血浆TMAO水平明显升高[(7.00±6.29)μmol/L vs(3.29±1.99)μmol/L,P<0.05]。多因素logistic回归分析校正性别、年龄、体质量指数和高脂血症以及合并疾病等因素后,血浆TMAO水平依然是LRNC形成的危险因素(P<0.05)。所有患者血浆TMAO水平与颈动脉斑块的TWV呈正相关(r=0.295,P<0.05);LRNC组患者血浆TMAO水平与LRNC大小呈正相关(r=0.576,P<0.01)。结论老年患者血浆TMAO水平与颈动脉斑块的LRNC形成及大小密切相关,且与TWV也密切相关。Objective To study the relationship between plasma trimethylamine N-oxide(TMAO)and carotid artery plaque(CAP)burden.Methods Seventy-nine suspected cardiocerebrovascular disease patients admitted to Affiliated Beijing Tiantan Hospital of Capital Medical University from January 2013 to December 2016 were divided into lipid-rich necrotic core(LRNC)group(n=23)and LRNC-free group(n=56).The plasma TMAO level and total wall volume(TWV)of CAP in two groups were measured by high-performance liquid chromatography and MRI respectively.The relationship between plasma TMAO level and CAP burden was analyzed by multivariate logistic regression analysis and Spearman correlation analysis respectively.Results The plasma TMAO level was significanrly higher in LRNC group than in LRNC-free group(7.00±6.29μmol/L vs 3.29±1.99μmol/L,P<0.05).Multivariate logistic regression analysis showed that plasma TMAO level was a risk factor for LRNC after adjustment of sex,age,BMI and concomitant diseases(P<0.05).Further analysis indicated that plasma TMAO level was closely related with the TWV of CAP(r=0.295,P<0.05)and the LRNC volume in elderly patients(r=0.576,P<0.01).Conclusion Plasma TMAO level is closely related with the volume of LRNC and the TWV of CAP in elderly patients.

关 键 词：斑块 动脉粥样硬化 颈总动脉 血脂异常 氧化三甲胺 

分 类 号：R743.3[医药卫生—神经病学与精神病学]