尿素、超敏C反应蛋白、同型半胱氨酸及血脂水平与颈动脉易损斑块和狭窄程度的相关性研究  

Study on the Correlation of Serum Urea,Hs-CRP,Homocysteine and Blood Lipid Levels with Carotid Plaque Stability and Stenosis

作　　者：张冬青 陈媛媛 ZHANG Dongqing;CHEN Yuanyuan(Department of Clinical Laboratory,the Fourth Medical Centre,Chinese PLA General Hospital,Beijing 100048,China;Department of Ultrasound,the Fourth Medical Centre,Chinese PLA General Hospital,Beijing 100048,China)

机构地区：[1]中国人民解放军总医院第四医学中心检验科,北京100048 [2]中国人民解放军总医院第四医学中心超声科,北京100048

出　　处：《标记免疫分析与临床》2024年第8期1382-1386,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨不同血清学指标与颈动脉易损斑块和狭窄程度的相关性。方法回顾性分析2021年11月至2022年11月我院就诊的476例颈动脉斑块患者,收集一般资料及其血清学数据。按照颈动脉超声检查将患者分为稳定斑块组(81例)和易损斑块组(395例),再根据狭窄程度,将患者分为轻度狭窄组(111例)、中度狭窄组(245例)和重度狭窄组(120例),检测比较各组血清学指标水平,采用ROC曲线分析评价血清学指标预测易损颈动脉斑块发生的价值,并应用Spearman相关性分析探讨血清学指标与颈动脉狭窄程度的关系。结果易损斑块组血清尿素、超敏C反应蛋白、同型半胱氨酸水平均高于稳定斑块组,易损斑块组血清载脂蛋白A和高密度脂蛋白胆固醇水平均低于稳定斑块组(P均<0.05);轻度狭窄组的APOA、HDL-C明显高于中度狭窄组和重度狭窄组,重度狭窄组的UREA、hs-CRP和Hcy明显高于轻度狭窄组和中度狭窄组(P均<0.05)。血清UREA、APOA、HDL-C、hs-CRP和Hcy联合预测发生颈动脉易损斑块的AUC为0.822,特异性、灵敏度分别为85.5%、75.2%。Sperman相关性分析显示,血清UREA、hs-CRP和Hcy与患者颈动脉狭窄程度呈正相关,血清APOA、HDL-C水平与患者颈动脉狭窄程度呈负相关(P<0.05)。结论血清UREA、APOA、HDL-C、hs-CRP和Hcy联合检测能够提高预测患者颈动脉易损斑块的准确性,并与患者颈动脉狭窄程度有关。Objective To investigate the correlation of different serum indicators with carotid plaque stability and stenosis.Methods The study was conducted on 476 carotid plaque patients admitted to this hospital from November 2021 to November 2022 were retrospectively analyzed.According to carotid ultrasound,the patients were divided into stable plaque group(81 cases)and unstable plaque group(395 cases).The degree of carotid stenosis was divided into mild stenosis group(111 cases),moderate stenosis group(245 cases)and severe stenosis group(120 cases).The general data and different serum indicators were compared among different groups.The receive operating characteristic(ROC)was used to evaluate the serum indicators on admission and the predictive value of the occurrence of unstable carotid plaque in patients.Spearman was used to analyze the correlation between the serum indicators and severity of carotid stenosis.Results The vulnerable plaque group had higher Urea,hs-CRP and Hcy,but lower Apo A and HDL-C when compared with the stable plaque group(all P<0.05).The levels of Apo A and HDL-C in the mild stenosis group were significantly higher than those in the moderate and severe stenosis groups.The levels of Urea,hs-CRP and Hcy in the severe stenosis group were higher than those in the mild and moderate stenosis group(all P<0.05).Receive operating characteristic(ROC)curve analysis indicated that the area under the curve(AUC)of Urea,Apo A,HDL-C,hs-CRP and Hcy for diagnosis plaque stability was 0.822,the specificity was 85.5%,and the sensitivity was 75.2%.Spearman correlation analysis suggested that Urea,hs-CRP and Hcy were positively correlated with the severity of carotid stenosis,but Apo A and HDL-C were negatively(P<0.05).Conclusion The levels of Urea,Apo A,HDL-C,hs-CRP and Hcy are related to the occurrence of carotid plaque stability and stenosis.

关 键 词：尿素 C反应蛋白质 同型半胱氨酸 载脂蛋白A 高密度脂蛋白胆固醇 颈动脉易损斑块 颈动脉狭窄 

分 类 号：R446[医药卫生—诊断学]