摘要
[目的]探讨凝血酶-抗凝血酶复合物(TAT)、组织型纤溶酶原激活物-抑制剂复合物(t-PAIC)、血栓调节蛋白(TM)在颅内动脉粥样硬化性狭窄(ICAS)患者血清中的水平,以及它们与狭窄程度的相关性。[方法]收集沧州市人民医院2021年1月—2023年2月期间进行治疗的196例ICAS患者(ICAS组)作为研究对象,根据血管的狭窄程度,将其分为轻度组(n=78)、中度组(n=64)和重度组(n=54);另选取196例与ICAS患者临床基本资料一致的同期门诊健康体检者作为对照组。比较各组血清TAT、t-PAIC、TM水平;Spearman法分析ICAS患者血清TAT、t-PAIC、TM水平与狭窄程度的相关性;多因素Logistic回归分析ICAS患者重度狭窄的影响因素;ROC曲线分析血清TAT、t-PAIC、TM、总胆固醇(TC)水平对ICAS患者发生重度狭窄的预测价值。[结果]与对照组相比,ICAS组血清TAT、t-PAIC、TM水平显著升高(P<0.05);ICAS轻度组、中度组、重度组血清TAT、t-PAIC、TM、TC水平依次升高,差异有统计学意义(P<0.05)。Spearman分析显示,ICAS患者血清TAT、t-PAIC、TM水平分别与狭窄程度呈正相关(r=0.574,0.695,0.628;均P<0.05)。多因素Logistic回归分析结果显示,TAT、t-PAIC、TM、TC是ICAS患者发生重度狭窄的独立危险因素(P<0.05)。ROC曲线显示,TAT、t-PAIC、TM、TC联合检测预测ICAS患者发生重度狭窄的AUC为0.927,灵敏度为83.33%,特异度为86.62%,优于各自单独预测(Z_(联合检测-TAT)=4.617、Z_(联合检测-t-PAIC)=4.024、Z_(联合检测-TM)=4.004、Z_(联合检测-TC)=7.078,均P=0.000)。[结论]ICAS患者血清TAT、t-PAIC、TM水平显著升高,且与狭窄严重程度呈正相关,这三者和TC联合检测对ICAS患者发生重度狭窄具有较高的预测价值。
Aim To investigate the serum levels of thrombin-antithrombin complex(TAT),tissue type plasminogen activator-inhibitor complex(t-PAIC)and thrombomodulin(TM)in patients with intracranial atherosclerotic stenosis(ICAS),and their correlations with the degree of stenosis.Methods A total of 196 ICAS patients(ICAS group)who underwent treatment in Cangzhou People s Hospital from January 2021 to February 2023 were enrolled as research subjects.Based on the degree of vascular stenosis,they were separated into three groups:mild group(n=78),moderate group(n=64),and severe group(n=54).A group of 196 healthy outpatient with similar clinical basic data to ICAS patients was selected as controls.The serum levels of TAT,t-PAIC,and TM in each group were compared;Spearman method was applied to analyze the correlation between serum levels of TAT,t-PAIC,TM and stenosis severity in ICAS patients;Multivariate Logistic regression was applied to analyze the influencing factors of severe stenosis in ICAS patients;ROC curve was applied to analyze the predictive value of serum TAT,t-PAIC,TM and total cholesterol(TC)levels for severe stenosis in ICAS patients.Results Compared with the control group,the serum levels of TAT,t-PAIC,and TM were significantly increased in the ICAS group(P<0.05);the levels of serum TAT,t-PAIC,TM,and TC in the mild,moderate,and severe groups increased accordingly(P<0.05).Spearman analysis showed that the serum levels of TAT,t-PAIC,and TM in ICAS patients were positively correlated with the degree of stenosis(r=0.574,0.695,0.628;all P<0.05).Multivariate Logistic regression analysis showed that TAT,t-PAIC,TM,and TC were independent risk factors for severe stenosis in ICAS patients(P<0.05).The ROC curve showed that the AUC of severe stenosis in ICAS patients predicted by combination of TAT,t-PAIC,TM,and TC was 0.927,with a sensitivity of 83.33%and a specificity of 86.62%,which was superior to the independent prediction of TAT,t-PAIC,TM and TC(Z_(combined detection-TAT)=4.617,Z_(combined detection-t-PAIC)=4.024,Z_(combined detection-TM)=4.004,Z_(combined detection-TC)=7.078,all P=0.000).Conclusion The serum levels of TAT,t-PAIC,and TM in the ICAS group were significantly increased,and were positively correlated with the severity of stenosis.The combination of the three and TC has a high predictive value for the occurrence of severe stenosis in ICAS patients.
作者
王澎
张春和
赵舰
褚宁涵
吕欣哲
张林
吴丹蕾
左瑞菊
张睿
WANG Peng;ZHANG Chunhe;ZHAO Jian;CHU Ninghan;LYU Xinzhe;ZHANG Lin;WU Danlei;ZUO Ruiju;ZHANG Rui(Clinical Medical Laboratory Center,Cangzhou People's Hospital,Cangzhou,Hebei 061000,China;Department of Neurosurgery,Cangzhou People's Hospital,Cangzhou,Hebei 061000,China;Cangzhou Central Blood Station Laboratory,Cangzhou,Hebei 061000,China;Department of Hematology,Cangzhou People's Hospital,Cangzhou,Hebei 061000,China)
出处
《中国动脉硬化杂志》
CAS
2024年第3期243-248,共6页
Chinese Journal of Arteriosclerosis
基金
沧州市科技计划自筹经费项目(222106126)。
