血清Lp-PLA2、PON-1及vWF水平对老年颈动脉狭窄患者颈动脉斑块稳定性的影响及临床预测价值  

Effects of serum Lp⁃PLA2,PON⁃1 and vWF levels on carotid plaque stability in elderly patients with carotid artery stenosis and their clinical predictive value

作　　者：张彩霞 马媛媛 崔二平 宋蕊楠 张丽丽 杨震 ZHANG Caixia;MA Yuanyuan;CUI Erping;SONG Ruinan;ZHANG Lii;YANG Zhen(Department of Neurology,Cangzhou People's Hospital,Cangzhou,Hebei,China,061000;Department of Clinical Laboratory,Cangzhou People's Hospital,Cangzhou,Hebei,China,061000)

机构地区：[1]沧州市人民医院神经内科,河北沧州061000 [2]沧州市人民医院检验科,河北沧州061000

出　　处：《分子诊断与治疗杂志》2023年第10期1698-1702,共5页Journal of Molecular Diagnostics and Therapy

基　　金：沧州市重点研发计划指导项目(192106028)。

摘　　要：目的 探究血清脂蛋白相关磷脂酶A2(Lp-PLA2)、对氧磷脂酶1(PON-1)及血管性血友病因子(vWF)对老年颈动脉狭窄患者颈动脉斑块稳定性的影响,并分析血清Lp-PLA2、PON-1及vWF水平对患者颈动脉斑块稳定性的预测价值。方法 选取2020年1月至2022年11月沧州市人民医院神经内一科收治的102例老年颈动脉狭窄合并颈动脉斑块的患者作为研究对象,利用核磁共振成像(MRI)检查患者的颈动脉血管与斑块稳定性,根据颈动脉内膜中层厚度(IMT)分为稳定斑块组(n=54)与不稳定斑块组(n=48);单因素分析比较两组的BMI指数、高血压病史、糖尿病史、吸烟史、血清Lp-PLA2、PON-1与vWF水平;通过多因素Logistic回归分析老年颈动脉狭窄患者颈动脉斑块稳定性的影响因素,并采用ROC曲线分析血清Lp-PLA2、PON-1与vWF水平对老年颈动脉狭窄患者颈动脉斑块稳定性的预测价值。结果 单因素分析结果显示,BMI指数、高血压病史、糖尿病史、吸烟史、血清Lp-PLA2、PON-1与vWF水平均是老年颈动脉狭窄患者颈动脉斑块稳定性的影响因素(P<0.05);多因素Logistic回归分析显示,有高血压病史(OR=1.908)、有糖尿病史(OR=1.621)、吸烟史>1年(OR=2.092)、血清Lp-PLA2水平升高(OR=2.104)、血清PON-1水平降低(OR=1.927)和血清vWF水平升高(OR=2.113)均是老年颈动脉狭窄患者颈动脉斑块稳定性的独立危险因素(P<0.05);ROC曲线分析显示血清Lp-PLA2、PON-1、vWF水平及联合检测的曲线下面积(AUC)分别为0.724、0.768、0.731、0.888,表明联合检测优于单一检测(P<0.05)。结论 血清Lp-PLA2、PON-1、vWF水平与老年颈动脉狭窄患者颈动脉斑块稳定性相关,且联合检测对老年颈动脉狭窄患者颈动脉斑块稳定性具有较好的预测价值。Objective To explore the effects of serum lipoprotein-associated phospholipase A2(Lp-PLA2),p-oxophospholipase 1(PON-1)and von Willebrand factor(vWF)on carotid plaque stability in elderly patients with carotid artery stenosis,and to analyze the predictive value of serum Lp-PLA2,PON-1 and vWF levels on carotid plaque stability in elderly patients with carotid artery stenosis.Methods A total of 102 elderly patients with carotid artery stenosis combined with carotid artery plaque admitted to the Department of Neurology of Cangzhou People's Hospital from January 2020 to November 2022 were selected as the study objects.Magnetic resonance imaging(MRI)was used to examine the carotid artery and plaque stability of the patients.Carotid intima-media thickness(IMT)was divided into the stable plaque group(n=54)and the unstable plaque group(n=48).The BMI,hypertension history,diabetes history,smoking history,serum Lp-PLA2,PON-1 and vWF levels of the two groups were compared by univariate analysis.Multivariate Logistic regression was used to analyze the factors affecting carotid plaque stability in elderly patients with carotid artery stenosis,and the ROC curve was used to analyze the predictive value of serum Lp-PLA2,PON-1 and vWF levels on carotid artery plaque stability in elderly patients with carotid artery stenosis.Results The results of univariate analysis showed that BMI,hypertension history,diabetes history,smoking history,serum Lp-PLA2,PON-1 and vWF levels were all influencing factors for carotid plaque stability in elderly patients with carotid artery stenosis(P<0.05).Multivariate Logistic regression analysis showed that A history of hypertension(OR=1.908),diabetes(OR=1.621),smoking history>1year(OR=2.092),elevated serum Lp-PLA2 level(OR=2.104),decreased serum PON-1 level(OR=1.927),and elevated serum vWF level(OR=2.113)were all associated with the elderly independent risk factors for carotid plaque stability in patients with arterial stenosis(P<0.05).The ROC curve analysis showed that serum Lp-PLA2,PON-1 and vWF level

关 键 词：颈动脉狭窄 颈动脉斑块 脂蛋白相关磷脂酶A2 对氧磷脂酶-1 血管性血友病因子 

分 类 号：R743[医药卫生—神经病学与精神病学]