血清vaspin、sVCAM-1、MCP-1、IL-6、hs-CRP水平与急性脑梗死患者颈动脉粥样硬化程度的相关性及对血管风险事件的预测价值  

Correlation between Serum vaspin,sVCAM-1,MCP-1,IL-6,hs-CRP Levels and the Degree of Carotid Atherosclerosis in Patients with Acute Cerebral Infarction and Its Predictive Value for Vascular Risk Events

作　　者：安仲武[1] 薄维波[1] 李欣 常焕显[1] AN Zhongwu;BO Weibo;LI Xin;CHANG Huanxian(Lianyungang Oriental Hospital,Jiangsu Province,Lianyungang 222042,China)

机构地区：[1]江苏省连云港市东方医院,江苏连云港222042

出　　处：《中国医学创新》2023年第35期145-150,共6页Medical Innovation of China

基　　金：江苏省卫生健康委科研项目(M2021100);南京医科大学康达学院科研发展基金(KD2022KYJJZD135)。

摘　　要：目的:探讨血清内脏脂肪特异性丝氨酸蛋白酶抑制剂(vaspin)、可溶性血管细胞黏附分子-1(sVCAM-1)、单核细胞趋化蛋白-1(MCP-1)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)水平与急性脑梗死(ACI)患者颈动脉粥样硬化(CAS)程度的相关性及对血管风险事件的预测价值。方法:选取2021年1月—2022年1月连云港市东方医院收治的106例ACI患者作为ACI组,另选取同期55例健康体检者作为对照组,所有受试者均接受血清vaspin、sVCAM-1、MCP-1、IL-6、hs-CRP水平检验,比较两组及ACI组不同CAS程度患者血清指标水平。分析血清vaspin水平与CAS程度的相关性及各指标水平对血管风险事件的预测价值。结果:ACI组血清vaspin水平较对照组更低(P<0.05),sVCAM-1、MCP-1、IL-6、hs-CRP均较对照组水平更高,差异均有统计学意义(P<0.05)。随着CAS程度加重,患者的血清vaspin水平降低,差异有统计学意义(P<0.05)。Spearman相关性分析显示,血清vaspin水平与ACI的CAS程度呈负相关(rs=-0.325,P<0.05)。106例ACI患者中,共有18例(16.98%)发生血管风险事件,单因素分析显示,有血管风险事件患者年龄、高血压病史、糖尿病史、吸烟史、血清vaspin、sVCAM-1、MCP-1、IL-6、hs-CRP与无血管风险事件患者比较,差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,血清sVCAM-1、MCP-1、IL-6、hs-CRP是ACI患者血管风险事件发生的独立危险因素(P<0.05),vaspin是ACI患者血管风险事件发生的保护因素(P<0.05)。受试者操作特征(ROC)曲线显示,血清vaspin、sVCAM-1、MCP-1、IL-6、hs-CRP预测ACI患者血管风险事件发生的曲线下面积分别为0.822、0.751、0.698、0.727、0.769(P<0.05)。结论:血清vaspin在ACI患者体内的水平偏低,该指标与CAS程度呈负相关,血清vaspin、sVCAM-1、MCP-1、IL-6、hs-CRP对ACI患者血管风险事件的发生有着较高的预测价值。Objective:To investigate the correlation between serum visceral adipose-specific serine protease inhibitor(vaspin),soluble vascular cell adhesion molecule-1(sVCAM-1),monocyte chemotactic protein-1(MCP-1),interleukin-6(IL-6)and hypersensitive C reactive protein(hs-CRP)levels and the degree of carotid atherosclerosis(CAS)in patients with acute cerebral infarction(ACI)and its predictive value for vascular risk events.Method:A total of 106 ACI patients were admitted to Lianyungang Oriental Hospital from January 2021 to January 2022 were selected as the ACI group,and 55 healthy physical examination people at the same time were selected as the control group.Serum levels of vaspin,sVCAM-1,MCP-1,IL-6,hs-CRP were tested in all subjects,serum indicators levels of patients with different CAS degrees were compared between the two groups and ACI group.The correlation between serum vaspin level and CAS degree and all indicators to their predictive value for vascular risk events were analyzed.Result:The serum vaspin level in the ACI group was lower than that in the control group,sVCAM-1,MCP-1,IL-6,hs-CRP were higher than those in the control group,the differences were statistically significant(P<0.05).As the degree of CAS increased,the serum vaspin levels of patients were decreased,the difference was statistically significant(P<0.05).Spearman correlation analysis showed a negative correlation between serum vaspin levels and the degree of CAS in ACI(rs=-0.325,P<0.05).A total of 18 cases(16.98%)of 106 patients with ACI had vascular risk events,univariate analysis showed that patients with vascular risk events had statistically significant differences in age,history of hypertension,history of diabetes,smoking history,serum vasopin,sVCAM-1,MCP-1,IL-6,hs-CRP compared to those patients without vascular risk events(P<0.05).Multivariate logistic regression analysis showed that serum sVCAM-1,MCP-1,IL-6 and hs-CRP were the independent risk factors for vascular risk events in ACI patients(P<0.05),vaspin was protective factor for vascular

关 键 词：内脏脂肪特异性丝氨酸蛋白酶抑制剂 急性脑梗死 颈动脉粥样硬化 血管风险事件 相关性 预测价值 

分 类 号：R743.3[医药卫生—神经病学与精神病学]