光学相干断层成像技术联合血清sLOX-1、Fractalkine在冠状动脉粥样硬化斑块易损性评估中的价值研究  

Value of optical coherence tomography combined with serum sLOX-1 and Fractalkine in the assessment of coronary atherosclerotic plaque vulnerability

作　　者：张鹏 代群丽 关顺凯 肖华凤 刘毅 孙玉春 刘璐璐 段书晨 高吉贤 ZHANG Peng;DAI Qunli;GUAN Shunkai;XIAO Huafeng;LIU Yi;SUN Yuchun;LIU Lulu;DUAN Shuchen;GAO Jixian(Department of Cardiology,Cangzhou People's Hospital,Cangzhou,Hebei 061000,China;Department of Electrocardiogram Room,Cangzhou People's Hospital,Cangzhou,Hebei 061000,China;Department of Otolaryngology,Cangzhou People's Hospital,Cangzhou,Hebei 061000,China)

机构地区：[1]河北省沧州市人民医院心内科,河北沧州061000 [2]河北省沧州市人民医院心电图室,河北沧州061000 [3]河北省沧州市人民医院耳鼻喉科,河北沧州061000

出　　处：《检验医学与临床》2025年第3期395-399,共5页Laboratory Medicine and Clinic

基　　金：河北省沧州市重点研发计划项目(222106094)。

摘　　要：目的探讨光学相干断层成像(OCT)技术联合血清可溶性凝集素样低密度脂蛋白受体-1(sLOX-1)、Fractalkine在冠状动脉粥样硬化(CA)斑块易损性评估中的价值。方法选取2023年3月至2024年2月在该院检查且确诊的96例CA患者作为研究对象,根据颅内动脉管壁高分辨率成像结果将其分为易损斑块组(40例)和非易损斑块组(56例)。检测两组血清sLOX-1、Fractalkine水平、斑块纤维帽厚度;采用Pearson相关分析血清sLOX-1、Fractalkine水平与斑块纤维帽厚度的相关性。采用一致性Kappa检验分析OCT及血清sLOX-1、Fractalkine单独及联合诊断斑块易损性与手术检查结果的一致性;绘制受试者工作特征(ROC)曲线分析血清sLOX-1、Fractalkine单独诊断斑块易损性的价值。采用诊断四格表分析OCT、血清sLOX-1、Fractalkine单独及三者联合检测诊断斑块易损性的价值。结果易损斑块组较非易损斑块组血清sLOX-1水平高于非易损斑块组,Fractalkine水平及斑块纤维帽厚度均低于非易损斑块组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,易损斑块组斑块纤维帽厚度与血清sLOX-1水平呈负相关(r=-0.411,P<0.05),与Fractalkine水平呈正相关(r=0.526,P<0.05)。ROC曲线分析结果显示,血清sLOX-1诊断斑块易损性的曲线下面积(AUC)为0.824(95%CI:0.736~0.912),灵敏度为70.00%,特异度为85.71%,最佳截断值为529.07 pg/mL;血清Fractalkine诊断斑块易损性的AUC为0.845(95%CI:0.770~0.921),灵敏度为77.50%,特异度为76.79%,最佳截断值为22.97 ng/mL。OCT检查结果与手术检查结果的一致性一般,Kappa值为0.379(P<0.05)。OCT联合血清sLOX-1、Fractalkine结果与手术检查结果的一致性较高,Kappa值为0.750(P<0.05)。OCT、血清sLOX-1、Fractalkine单独诊断斑块易损性的灵敏度低于三者联合诊断,漏诊率高于三者联合诊断,差异均有统计学意义(P<0.05)。结论斑块易损CA患者的血清sLOX-1水平升高,Fractalkine水平降Objective To investigate the value of optical coherence tomography(OCT)combined with serum soluble lectin like low density lipoprotein receptor-1(sLOX-1)and Fractalkine in the assessment of coronary atherosclerotic(CA)plaque vulnerability.Methods A total of 96 patients with CA who were examined and diagnosed in this hospital from March 2023 to February 2024 were selected as the research objects.According to the results of high-resolution imaging of intracranial artery wall,they were divided into vulnerable plaque group(40 cases)and non-vulnerable plaque group(56 cases).The serum levels of sLOX-1 and Fractalkine and the fibrous cap thickness of plaque were detected.Pearson correlation analysis was used to analyze the correlation between serum sLOX-1,Fractalkine levels and plaque fibrous cap thickness.Kappa test was used to analyze the consistency of OCT,sLOX-1 and Fractalkine alone or in combination in the diagnosis of plaque vulnerability and the results of surgical examination.The receiver operating characteristic(ROC)curve was drawn to analyze the value of serum sLOX-1,Fractalkine in the diagnosis of plaque vulnerability.The diagnostic four-fold table was used to analyze the value of OCT,serum sLOX-1 and Fractalkine alone and their combination in the diagnosis of plaque vulnerability.Results The serum sLOX-1 level in the vulnerable plaque group was higher than that in the non-vulnerable plaque group,and the Fractalkine level and the fibrous cap thickness in the plaque group were lower than those in the non-vulnerable plaque group,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that the fibrous cap thickness of plaque in the vulnerable plaque group was negatively correlated with serum sLOX-1 level(r=-0.411,P<0.05),and positively correlated with serum Fractalkine level(r=0.526,P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum sLOX-1 for diagnosing plaque vulnerability was 0.824(95%CI:0.736-0.912),the sensitivity was 70.00%,the specificity w

关 键 词：光学相干断层成像 冠状动脉粥样硬化 斑块易损性 可溶性凝集素样低密度脂蛋白受体-1 FRACTALKINE 

分 类 号：R543.3[医药卫生—心血管疾病] R543.5[医药卫生—内科学]