老年脑梗死颈动脉粥样硬化易损斑块与血清RBP4水平及氧化应激的关系  

Relationship between carotid atherosclerotic vulnerable plaque and serum RBP4 level and oxidative stress in elderly patients with cerebral infarction

作　　者：王青青 肖大海 田沙 赵若彤 张晓璇[1] 焦光美[1] 马征[1] WANG Qing-qing;XIAO Da-hai;TIAN Sha;ZHAO Ruo-tong;ZHANG Xiao-xuan;JIAO Guang-mei;MA Zheng(Department of Neurology,Affiliated Hospital of Chengde Medical College,Chengde 067000,Hebei,China;Department of Emergency,Affiliated Hospital of Chengde Medical College,Chengde 067000,Hebei,China)

机构地区：[1]承德医学院附属医院神经内科,承德067000 [2]承德医学院附属医院急诊科,承德067000

出　　处：《医学研究生学报》2022年第12期1288-1293,共6页Journal of Medical Postgraduates

基　　金：河北省卫生和计划生育委员会资助项目(20181160)。

摘　　要：目的 脑梗死是威胁老年人健康的主要疾病。文中分析老年脑梗死患者血清视黄醇结合蛋白4(RBP4)水平的变化,及其与氧化应激、颈动脉粥样硬化易损斑块的关系。方法 前瞻性纳入就诊于承德医学院附属医院神经内科的老年脑梗死患者136例,依据颈部血管超声检查结果将受试者分为内膜增厚组31例、稳定斑块组51例、易损斑块组54例,另选取同期健康体检者40例作为对照组。采用酶联免疫法检测血清RBP4水平、8-异前列腺素F2α(8-iso-PGF2α)和过氧化氢酶(CAT)水平,彩色血管多普勒超声仪测量颈动脉粥样斑块面积和内-中膜厚度(IMT)。结果 对照组、内膜增厚组、稳定斑块组、易损斑块组的血清RBP4、8-iso-PGF2α、IMT、颈动脉粥样斑块面积均呈明显递增趋势,血清CAT呈明显递减趋势,差异有统计学意义(P<0.05)。老年脑梗死患者血清RBP4水平与8-iso-PGF2α(r=0.486)、IMT(r=0.542)、颈动脉粥样斑块面积(r=0.388)呈正相关(P<0.05),与CAT呈负相关(r=-0.724,P<0.05)。血清RBP4预测颈动脉易损斑块发生的AUC为0.778,当Cut-off值为22.215mg/L时,其敏感性为81.5%、特异性为64.8%。结论 老年脑梗死患者血清RBP4水平明显升高;且升高的RBP4水平与氧化应激损伤及颈动脉粥样硬化程度呈正相关。血清RBP4水平对老年脑梗死患者颈动脉易损斑块具有一定诊断价值。Objective Cerebral infraction is the main disease threatening the health of the elderly people. The paper aims to analyze the changes of serum retinol-binding protein 4(RBP4) in elderly patients with cerebral infarction and its relationship with oxidative stress and vulnerable plaque of carotid atherosclerosis. Methods A total of 136 elderly patients with cerebral infarction admitted to the Department of Neurology, Affiliated Hospital of Chengde Medical College were prospectively included. According to the results of cervical vascular ultrasonography, the subjects were divided into endometrial thickening group(n=31), stable plaque group(n=51) and vulnerable plaque group(n=54), and 40 healthy subjects were selected as the control group. Serum RBP4 levels, 8 isoprostane(8-iso-PGF2α) and catalase(CAT) levels were detected by enzyme-linked immunosorbent assay. Carotid atherosclerotic plaque area and intima-media thickness(IMT) were measured by color doppler ultrasonography. Results Serum RBP4, 8-iso-PGF2α, IMT and carotid atherosclerotic plaque area showed a significant increase in control group, intima thickening group, stable plaque group and vulnerable plaque group, while serum CAT showed a significant decrease, and the differences were statistically significant(P<0.05). Serum RBP4 level was positively correlated with 8-iso-PGF2α(r=0.486), IMT(r=0.542), carotid atherosclerotic plaque area(r=0.388)(P<0.05), and negatively correlated with CAT(r=-0.724, P<0.05). Serum RBP4 predicted the occurrence of vulnerable carotid plaque with an AUC of 0.778, and its sensitivity and specificity were 81.5% and 64.8% when the cut-off value was 22.215mg/L. Conclusion The level of serum RBP4 in elderly patients with cerebral infarction was significantly increased, and the increased level of RBP4 was positively correlated with oxidative stress injury and carotid atherosclerosis. Serum RBP4 level has certain diagnostic value for vulnerable carotid plaque in elderly patients with cerebral infarction.

关 键 词：脑梗死 视黄醇结合蛋白4 氧化应激 颈动脉粥样硬化 易损斑块 

分 类 号：R743[医药卫生—神经病学与精神病学]