摘要
目的探讨急性脑梗死患者血清Angpls 2水平对颈动脉粥样硬化斑块稳定性的影响。方法选取2014-03—2017-04在郑州大学第五附属医院神经内科住院治疗的初诊急性脑梗死患者191例,根据颈动脉超声检查结果分为稳定性斑块组(n=57)、不稳定性斑块组(n=69)和无斑块组(n=65),同期,选取健康者45例作为对照组,收集临床资料,利用酶联免疫吸附试验(ELISA法)检测血清Angptl 2水平。结果急性脑梗死患者血清Angptl 2水平为(3. 74±0. 97)ng/mL,对照组为(1. 14±0. 17) ng/mL,差异有统计学意义(t=17. 871,P=0. 000);不稳定性斑块组TC、LDL-C、hs-CRP和Angptl 2均高于稳定性斑块组和无斑块组,而HDL-C低于稳定性斑块组和无斑块组,且稳定性斑块组Angptl 2高于无斑块组,差异有统计学意义(P<0. 05); Pearson相关分析显示,急性脑梗死患者血清Angptl 2水平与LDL-C和hs-CRP均呈正相关(r=0. 234和0. 618; P=0. 001和0. 000),而与HDL-C呈负相关(r=-0. 183,P=0. 011);多因素Logistic回归分析显示,hs-CRP和血清Angptl 2水平是影响颈动脉粥样硬化斑块稳定性的独立风险因素(P<0. 05); ROC曲线分析显示,血清Angptl 2水平在判定颈动脉粥样硬化斑块稳定性时,曲线下面积0. 900(95%CI:0. 848～0. 953),当血清Angptl 2取4. 16ng/mL时,灵敏度79. 7%,特异度87. 7%。结论急性脑梗死患者血清Angptl 2水平升高,且与颈动脉粥样硬化斑块稳定性有关,是影响颈动脉粥样硬化斑块稳定性的独立风险因素。
Objective To investigate the effect of serum level of Angpls 2 on the stability of carotid atherosclerotic plaques in patients with acute cerebral infarction.Methods 191 cases of patients wieh newly diagnosed acute cerebral infarction were selected from March 2014 to April 2017 in the Fifth Affiliated Hospital of Zhengzhou University.According to carotid ultrasonography results,the patients were divided into stable plaque group(n=65),unstable plaque group(n=69)and no plaque group(n=65).In the same period,45 healthy subjects were selected as the control group.The clinical data was collected.The serum level of Angptl 2 was measured by enzyme linked immunosorbent assay(ELISA).Results The serum level of Angptl 2 in patients with acute cerebral infarction was(3.74±0.97)ng/mL,and the serum level of Angptl 2 in the control group was(1.14±0.17)ng/mL,the difference was statistically significant(t=17.871,P=0.000).The TC,LDL-C,hs-CRP and Angptl 2 in the unstable plaque group were higher than those in the stable plaque group and the no plaque group,while the HDL-C was lower than the stable plaque group and the no plaque group,and the Angptl 2 in the stable plaque group was higher than the no plaque group,the difference were statistically significant(P<0.05).Pearson correlation analysis showed that the serum level of Angptl 2 in patients with acute cerebral infarction was positively correlated with LDL-C and hs-CRP(r=0.234 and 0.618,P=0.001 and 0.000),while was negatively correlated with HDL-C(r=0.183,P=0.011).Multivariate logistic regression analysis showed that hs-CRP and serum level of Angptl 2 were independent risk factors for the stability of carotid atherosclerotic plaques(P<0.05).ROC curve analysis showed that the area under the curve for the serum level of Angptl 2 in predicting the stability of carotid atherosclerotic plaque was 0.900(95%CI:0.848 0.953),when the serum Angptl 2 was 4.16 ng/mL,the sensitivity was 79.7%and the specificity was 87.7%.Conclusion The serum level of Angptl 2 in patients with acute cerebral infarction was increased,and was related with the stability of carotid atherosclerotic plaques.It was an independent risk factor for the stability of carotid atherosclerotic plaques.
作者
李魁
何远宏
LI Kui;HE Yuanhong(Department of Neurology,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中国实用神经疾病杂志》
2018年第22期2476-2481,共6页
Chinese Journal of Practical Nervous Diseases
