腹主动脉瘤患者血浆DDP4水平与动脉瘤进展的关系  

Relationship between plasma DDP4 level and aneurysm progression in patients with abdominal aortic aneurysm

作　　者：毕远航 王吉昌[2] 付浩哲 BI Yuan-hang;WANG Ji-chang;FU Hao-zhe(Department of Vascular Surgery,Baoji Central Hospital,Baoji Shaanxi 721000,China;Department of Vascular Surgery,First Affiliated Hospital of Xi'an Jiaotong University,Xi'an Shaanxi 710000,China)

机构地区：[1]宝鸡市中心医院血管外科,陕西宝鸡721000 [2]西安交通大学第一附属医院血管外科,陕西西安710000

出　　处：《局解手术学杂志》2025年第1期67-71,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：陕西省科学技术研究发展计划项目(2020J16-06-01)。

摘　　要：目的 探讨腹主动脉瘤患者血浆二肽基肽酶4(DDP4)水平与动脉瘤进展的关系。方法 选取2020年1月至2021年5月宝鸡市中心医院收治的43例腹主动脉瘤患者为研究对象。随访至少12个月,根据首次和末次计算机断层扫描血管造影数据获取最大瘤体前后直径的绝对测量值和进展速度,根据腹主动脉瘤进展速度将患者分为进展组(进展速度≥0.5 mm/年)和无进展组(进展速度<0.5 mm/年),比较2组患者临床特征。酶联免疫吸附法检测患者入院时血浆DDP4水平。采用Pearson相关性和多元线性回归分析DDP4与腹主动脉瘤进展速度的相关性。使用Logistic回归模型和受试者工作特征(ROC)曲线分析血浆DDP4对腹主动脉瘤进展的预测效能。结果 进展组患者腔内血栓厚度(P=0.046)和腹主动脉瘤进展速度(P<0.001)大/快于无进展组,且血浆DDP4水平显著高于无进展组(P<0.001)。多因素Logistic回归分析显示,血浆DDP4水平是腹主动脉瘤进展的独立预测因素(P<0.05)。经Pearson相关性分析,血浆DDP4水平与腹主动脉瘤进展速度呈显著正相关(r=0.517,P<0.001)。经多元线性回归校正其他混杂因素后,血浆DDP4水平与腹主动脉瘤进展速度仍呈显著正相关(β=0.312,95%CI:0.002~0.484,P=0.048)。基线血浆DDP4水平预测腹主动脉瘤进展的曲线下面积为0.840(95%CI:0.704~0.976),对应截断值为13.89 pg/mL,特异度为85.7%,敏感度为79.3%。结论 腹主动脉瘤患者血浆DDP4水平升高与腹主动脉瘤进展高风险有关,血浆DDP4有望成为预测腹主动脉瘤进展的生物标志物。Objective To investigate the relationship between plasma dipeptidyl peptidase 4(DDP4) level and the progression of abdominal aortic aneurysm.Methods Forty-three patients with abdominal aortic aneurysm admitted to Baoji Central Hospital from January 2020 to May 2021 were selected.The follow-up was conducted at least 12 months,the absolute measurement of the maximum anteriorposterior diameters of the aneurysm and the rate of progression were obtained based on the first and last computed tomography angiography data,and the patients were divided into the progression group(with the rate of progression≥0.5 mm/year) and the progression-free group(with the rate of progression<0.5 mm/year) according to the rate of the abdominal aortic aneurysm progression.The clinical characteristics of the two groups were compared.Plasma DDP4 levels were detected by enzyme-linked immunosorbent assay.The correlation between plasma DDP4 and the rate of abdominal aortic aneurysm progression was analyzed by Pearson correlation and multiple linear regression.The predictive performance of plasma DDP4 on abdominal aortic aneurysm progression was analyzed by Logistic regression model and receiver operating characteristic(ROC) curve.Results The thickness of intracavitary thrombus(P=0.046) and the rate of abdominal aortic aneurysm progression(P<0.001) in the progression group were greater/faster than those in the the progression-free group,and the plasma level of DDP was significantly higher than that in the progression-free group(P<0.001).Multivariate Logistic regression analysis showed that plasma DDP4 level was an independent predictor of abdominal aortic aneurysm progression(P<0.05).Pearson correlation analysis showed that plasma DDP4 level was positively correlated with the rate of abdominal aortic aneurysm progression(r=0.517,P<0.001).After adjusting for other confounding factors,multiple linear regression showed that there was still a significantly positive correlation between plasma DDP4level and abdominal aortic aneurysm progression rat

关 键 词：腹主动脉瘤 血浆二肽基肽酶4 疾病进展 

分 类 号：R654.3[医药卫生—外科学]