摘要
目的检测可溶性尿激酶型纤溶酶原激活物受体(suPAR)和D-二聚体在动脉粥样硬化性脑梗死(ACI)患者血液中的水平,并探讨其与动脉粥样硬化斑块稳定性的关系。方法回顾性分析2017年1月~2018年1月中南大学湘雅医院收治的90例ACI患者的临床资料,根据患者颈动脉斑块的稳定性分为斑块稳定组(42例)和斑块不稳定组(48例),并择取同期门诊健康体检者50名作为对照组。检测并比较三组受检者血液中suPAR和D-二聚体水平,分析其与颈动脉斑块稳定性的关系。结果①三组患者suPAR、D-二聚体表达水平比较,差异有高度统计学意义(P<0.01),其中不稳定斑块组suPAR、D-二聚体水平明显高于斑块稳定组和对照组(P<0.01),斑块稳定组suPAR、D-二聚体水平明显高于对照组(P<0.01);②suPAR和D-二聚体是影响斑块稳定性的危险因素[OR=1.068,95%CI(0.002~0.215),P<0.05;OR=1.013,95%CI(0.014~0.462),P<0.05];③suPAR预测斑块稳定性最佳界值为8.04ng/mL,曲线下面积为0.660(95%CI:62.7%~96.5%,P<0.05)。D-二聚体预测斑块稳定性最佳界值为3.92ng/mL,曲线下面积为0.837(95%CI:66.1%~99.8%,P<0.05)。结论suPAR和D-二聚体可以作为ACI患者斑块易损性的评估指标。
Objective To measure the levels of soluble urokinase plasminogen activator receptor(suPAR)and D-dimer in patients with atherosclerotic cerebral infarction(ACI),and to explore the correlation between them and carotid plaque stability.Methods The clinical data of 90 patients with ACI admitted to Xiangya Hospital of Central South University from January 2017 to January 2018 was retrospectively analyzed and the patients were divided into instability plaque group(42 cases)and unstable plaques group(48 cases)by stability of carotid atherosclerosis.While 50 cases of outpatient health examinations were selected as control group at the same time.The plasma suPAR and D-dimer levels were detected and compared among the three groups.The correlation of plasma suPAR and D-dimer levels with carotid plaque stability was analyzed.Results①The difference in suPAR and D-dimer expression among three groups was statistically significant(P<0.01),suPAR and D-dimer levels in the unstable plaque group were significantly higher than those in the stable plaque group and the control group(P<0.01),and suPAR and D-dimer levels in the plaque stability group were significantly higher than those in the control group(P<0.01).②suPAR and D-dimer were risk factors for plaque stability[OR=1.068,95%CI(0.002-0.215),P<0.05;OR=1.013,95%CI(0.014-0.462),P<0.05].③The optimal cut-off point for suPAR to predict the unstability of carotid plaques was 8.04 ng/mL.The area under the ROC curve was 0.660(95%CI:62.7%-96.5%,P<0.05).The optimal cut-off point for D-dimer to predict the unstability of carotid plaques was 3.92 ng/mL.The area under the ROC curve was 0.837(95%CI:66.1%-99.8%,P<0.05).Conclusion suPAR and D-dimer can be indicators to evaluate carotid plaque stability in patients with atherosclerotic cerebral infarction.
作者
邹兰
李国良
严小新
ZOU Lan;LI Guoliang;YAN Xiaoxin(Department of Neurology,Xiangya Hospital of Central South University,Hu′nan Province,Changsha 410005,China;School of Basic Medicine,Central South University,Hu′nan Province,Changsha 410013,China)
出处
《中国医药导报》
CAS
2019年第14期47-50,共4页
China Medical Herald
基金
国家自然科学基金资助项目(91632116)
