血管性血友病因子、同型半胱氨酸和内皮细胞微粒体水平与颈动脉不同狭窄程度的相关性及临床预测价值研究  

Study on the Correlation of von Willebrand Factor,Homocysteine,and Endothelial Microsome Level with Different Degree of Carotid Artery Stenosis and Its Clinical Prediction Value

作　　者：陈静 周慧敏 钟纯正 CHEN Jing;ZHOU Hui-min;ZHONG Chun-zheng(Department of Neurology,Danzhou People’s Hospital,Danzhou 571799,China)

机构地区：[1]儋州市人民医院神经内科,儋州571799

出　　处：《中国临床神经科学》2024年第6期636-642,共7页Chinese Journal of Clinical Neurosciences

基　　金：海南省卫生健康行业科研项目(编号:20A190026)。

摘　　要：目的探讨血管性血友病因子(vWF)、同型半胱氨酸(Hcy)、内皮细胞微粒体(EMP)水平与颈动脉不同狭窄程度的关系及临床预测价值。方法回顾性分析2021年1月至2022年1月收治150例确诊颈动脉狭窄患者的临床资料,按照颈动脉狭窄分级分为轻度组(56例)、中度组(53例)和重度组(41例)。使用酶联免疫吸附试验检测血清vWF、Hcy水平;流式细胞双色法检测EMP水平;收集各组一般临床资料及血清vWF、Hcy、EMP水平;用Spearman相关系数分析vWF、Hcy、EMP与颈动脉不同狭窄程度之间的相关性;绘制受试者操作特征曲线(ROC)分析vWF、Hcy、EMP监测对颈动脉狭窄的预测价值。结果3组间的vWF、Hcy、EMP水平比较,重度组vWF、Hcy、EMP水平较中度组均显著增高(均P<0.05),中度组较轻度组均显著增高(均P<0.05)。单因素及多因素Logistic回归分析显示vWF、Hcy、EMP、BMI均是引发患者颈动脉产生不同程度狭窄的危险因素(均P<0.05)。分别按BMI、HDL-C、LDL-C不同水平为分亚组进行交互检验,分析显示:BMI>25.02 kg/m^(2)亚组vWF、Hcy、EMP水平均显著高于≤25.02 kg/m^(2)亚组(交互检验P=0.023、0.028、0.009);HDL-C>1.41 mmol·L^(-1)亚组vWF、Hcy、EMP水平均显著高于≤1.41 mmol·L^(-1)亚组(交互检验P=0.017、0.035、0.033);Spearman相关系数显示vWF、Hcy、EMP水平与颈动脉狭窄程度均呈显著正相关(P<0.05);ROC曲线示vWF、Hcy、EMP联合诊断的曲线下面积均高于单一检测,敏感度为89.20%,特异度为87.20%。结论颈动脉狭窄程度与vWF、Hcy、EMP水平均呈显著正相关,即vWF、Hcy、EMP越高,颈动脉狭窄越严重,通过联合vWF、Hcy、EMP检测对临床判断患者颈动脉狭窄程度具有较高的预测价值。Aim To investigate the relationship between von Willebrand factor(vWF),homocysteine(Hcy),endothelial microsome(EMP)levels and different degree of carotid artery stenosis and its clinical prediction value.Methods The clinical data of 150 patients with carotid artery stenosis diagnosed in our hospital from January 2021 to January 2022 were retrospectively analyzed,and they were divided into a mild group(56 cases),a moderate group(53 cases)and a severe group(41 cases)according to the grade of carotid artery stenosis.Serum vWF and Hcy were detected by enzyme linked immunosorbent assay.The general data and the expression levels of vWF,Hcy and EMP in serum were observed.Spearman correlation coefficient was used to analyze the correlation between the expression of vWF,Hcy,EMP and the degree of carotid stenosis.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of vWF,Hcy and EMP monitoring for carotid artery stenosis.Results The expression of vWF,Hcy and EMP in severe group was significantly higher than that in the moderate group,and the moderate group was significantly higher than that in the mild group(all P<0.05).Univariate and multivariate analysis showed that vWF,Hcy,EMP and BMI were risk factors for different degrees of carotid artery stenosis(all P<0.05).Subgroup analysis showed that the levels of vWF,Hcy and EMP in>25.02 kg/m^(2) subgroup were significantly higher than those in≤25.02 kg/m^(2) subgroup(cross-test value P=0.023,0.028,0.009).The levels of vWF,Hcy and EMP in>1.41 mmol·L^(-1) subgroup were significantly higher than those in≤1.41 mmol·L^(-1) subgroup(cross-test value P=0.017,0.035,0.033);Spearman correlation coefficient showed that the expressions of vWF,Hcy,EMP were significantly positively correlated with the degree of carotid artery stenosis(P<0.05).The ROC curve showed that the area under the curve of vWF,Hcy and EMP combined diagnosis was higher than that of the single detection,with a sensitivity of 89.20%and a specificity of 87.20%.Conclusion The degree

关 键 词：血管性血友病因子 同型半胱氨酸 内皮细胞微粒体 颈动脉狭窄 相关性 

分 类 号：R543.4[医药卫生—心血管疾病]