血清sdLDL-C、Lp-PLA2及GDF-15在颈动脉粥样硬化中的应用价值  

The value of serum sdLDL-C,Lp-PLA2 and GDF-15 in carotid atherosclerosis

作　　者：张帆 赵博 张志伟 张丽平 苏慧芳 ZHANG Fan;ZHAO Bo;ZHANG Zhiwei;ZHANG Liping;SU Huifang(Department of Neurology,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei,075000,China)

机构地区：[1]河北北方学院附属第一医院神经内科,河北张家口075000

出　　处：《临床血液学杂志》2025年第2期113-116,121,共5页Journal of Clinical Hematology

基　　金：张家口市科学技术局2023年市级科技计划自筹经费项目(No:2322146D)。

摘　　要：目的:探讨血清小而密低密度脂蛋白胆固醇(sdLDL-C)、脂蛋白相关磷脂酶A2(Lp-PLA2)及生长分化因子-15(GDF-15)与颈动脉粥样硬化(CAS)的关系。方法:选择2020年8月—2021年3月河北北方学院附属第一医院经颈动脉彩超诊断的颈动脉内膜中层厚度(IMT)异常者119例。选择同时期入院健康体检者89例作为参照组。IMT异常者被分成IMT增厚组(49例)和斑块组(70例)。Spearman相关性分析sdLDL-C、Lp-PLA2及GDF-15同年龄、体质指数(BMI)、总胆固醇(TC)、甘油三酯(TG)、LDL-C、高密度脂蛋白胆固醇(HDL-C)、舒张压(SBP)、收缩压(DBP)的相关性。Logistic回归分析评估诱发CAS斑块的独立风险因素。结果:与参照组比较,IMT增厚组年龄较大,患者SBP、sdLDL-C、Lp-PLA2、GDF-15水平均较高(P<0.05);与参照组比较,斑块组糖尿病患者占比高、SBP、DBP明显增高,TC、LDL-C、sdLDL-C、Lp-PLA2、GDF-15水平较高(P<0.05),HDL-C水平较低(P<0.05),且斑块组SBP、DBP、sdLDL-C、Lp-PLA2、GDF-15水平高于IMT增厚组(P<0.05)。Spearman相关分析显示:IMT异常者中sdLDL-C与年龄、BMI、LDL-C、TC、TG、SBP、DBP、Lp-PLA2、GDF-15呈正相关,与HDL-C呈负相关。Lp-PLA2、GDF-15与年龄、LDL-C、TC、SBP、DBP呈正相关,与HDL-C呈负相关。Logistic回归分析显示:年龄(OR=7.965,95%CI 1.349~47.029)、糖尿病(OR=1.148,95%CI 1.072~1.229)、sdLDL-C(OR=2.234,95%CI 1.583~3.155)、Lp-PLA2(OR=1.254,95%CI 1.061~1.481)、GDF-15(OR=1.853,95%CI 1.512~2.272)是动脉粥样硬化发生的风险因素。结论:血清sdLDL-C、Lp-PLA2及GDF-15水平对颈动脉斑块有较好的预测价值,是评估CAS的重要风险因素。Objective:To explore the relationship among small and dense low density lipoprotein cholesterol(sdLDL-C),lipoprotein-associated phospholipase A2(Lp-PLA2),growth differentiation factor-15(GDF-15)and carotid atherosclerosis.Methods:A total of 119 patients with abnormal carotid intima-media thickness(IMT)diagnosed by carotid ultrasound in the First Affiliated Hospital of Hebei North University from August 2020 to March 2021 were selected as the study subjects.A total of 89 healthy people were randomly selected as the control group from the physical examination center during the same period.Spearman correlation analysis was conducted to investigate the correlation between sdLDL-C,Lp-PLA2,and GDF-15 with age,body mass index(BMI),total cholesterol(TC),triglycerides(TG),LDL-C,HDL-C,diastolic blood pressure(SBP),and systolic blood pressure(DBP).Logistic stepwise regression analysis evaluated independent risk factors for CAS.Results:Compared with the control group,the IMT thickening group was older and had higher levels of SBP,sdLDIL-C,Lp-PLA2 and GDF-15(P<0.05);Compared with the control group,the plaque group had a high proportion of patients with diabetes,SBP,DBP increased significantly,and the levels of TC,LDL-C,sdLDL-C,Lp-PLA2 and GDF-15 were higher(P<0.05),HDL-C was lower(P<0.05),and the levels of SBP,DBP,sdLDL-C,Lp-PLA2 and GDF-15 in the plaque group were also significantly higher than those in the IMT thickening group(P<0.05).Spearman correlation analysis showed that sdLDL-C in the group with carotid artery abnormalities was positively correlated with age,BMI,LDL-C,TC,TG,SBP,DBP,Lp-PLA2,GDF-15,and negatively correlated with HDL-C.Lp-PLA2 and GDF-15 were positively correlated with age,LDL-C,TC,SBP,DBP and negatively correlated with HDL-C.Logistic regression analysis showed that age(OR=7.965,95%CI 1.349-47.029),diabetes(OR=1.148,95%CI 1.072-1.229),sdLDL-C(OR=2.234,95%CI 1.583-3.155),Lp-PLA2(OR=1.254,95%CI 1.061-1.481),GDF-15(OR=1.853,95%CI 1.512-2.272)were risk factors for AS.Conclusion:The levels of sdLDL-C,Lp-PLA2

关 键 词：颈动脉粥样硬化 小而密低密度脂蛋白胆固醇 脂蛋白相关磷脂酶A2 生长分化因子-15 

分 类 号：R446.11[医药卫生—诊断学]