摘要
目的研究急性脑梗死(ACI)患者在介入治疗前后血清血管生成素样蛋白4(ANGPTL4)与沉默信息调节蛋白1(SIRT1)水平的变化及与预后联系。方法回顾性分析2020年1月-2022年1月于上海交通大学附属松江医院开展介入治疗的231例ACI患者及同时间段的72例健康体检者(对照组)临床资料。在介入治疗开展前结合颈动脉检查结果将ACI患者划分为不稳定组(n=141)、稳定组(n=54)、无斑块组(n=36)。对比各组患者血清ANGPTL4与SIRT1水平,分析其与介入治疗不良预后的关系。结果ACI患者介入治疗前后血清ANGPTL4以及SIRT1水平较对照组患者更低(P<0.001);不稳定组患者在血清超敏C反应蛋白(hs-CRP)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)等指标水平较稳定组更高(P<0.05)。ROC曲线结果显示,ANGPTL4预测患者颈动脉粥样斑块不稳定性AUC为0.797(0.733~0.851),SIRT1为0.751(0.684~0.810)。多因素Logistic回归分析结果表明,hs-CRP、ANGPTL4、SIRT1是动脉粥样硬化斑块不稳定的独立危险因素(P<0.05)。结论ACI患者血清ANGPTL4、SIRT1水平降低参与颈动脉粥样硬化(CAS)形成及发展过程,并可作为ACI患者CAS斑块不稳定性的预测指标。
Objective To investigate the changes of serum ANGPTL4 and SIRT1 in patients with acute cerebral infarction(ACI)before and after interventional therapy and the correlation with prognosis.Methods The study included 231 patients with acute cerebral infarction undergoing interventional therapy in our hospital from January 2020 to January 2022 and randomly selected 72 healthy physical examination subjects during the same period as the control group.Before interventional therapy,patients with ACI were divided into unstable group(n=141),stable group(n=54),and no plaque group(n=36)based on the results of carotid artery examination.The correlation between the changes of serum ANGPTL4/SIRT1 and poor prognosis of interventional therapy wasanalyzed.Results The serum of ANGPTL4 and SIRT1 in ACI patients before and after interventional treatment were lower than those in the control group(P<0.001).The levels of serum hypersensitive C-reactive protein(hs-CRP),total cholesterol(TC)and low-density lipoprotein cholesterol(LDL-C)in the unstable group were higher than those in the stable group(P<0.05).ROC curve showed that the ANGPTL4 and SIRT1 in patients with carotid atherosclerotic plaque instability was 0.797(0.733-0.851)and 0.751(0.684-0.810).Multivariate Logistic regression analysis showed that hs-CRP,ANGPTL4 and SIRT1 were independent risk factors for atherosclerotic plaque instability(P<0.05).Conclusion The decreased levels of serum ANGPTL4 and SIRT1 in ACI patients are involved in the formation and development of carotid atherosclerosis(CAS),and can be used as a predictor of CAS plaque instability in patients with acute cerebral infarction.
作者
袁建英
娄华聪
姜友亮
王晓
YUAN Jianying;LOU Huacong;JIANG Youliang;WANG Xiao(Department of Emergency Critical Care,Shanghai Songjiang District Center Hospital,Shanghai 201600,China;First Aid Center of Songjiang District,Shanghai 201600,China)
出处
《医学研究与战创伤救治》
CAS
北大核心
2023年第6期615-618,共4页
Journal of Medical Research & Combat Trauma Care
关键词
急性脑梗死
血管生成素样蛋白4
沉默信息调节蛋白1
acute cerebral infarction
angiopoietin-like protein 4
silencing information regulator 1
作者简介
通信作者:王晓,E-mail:jijiuwangxiao120@sina.com。
