摘要
目的分析微栓子信号(MES)检出率、血清脂蛋白相关磷脂酶A2(LP-PLA2)、血管细胞粘附分子-1(VCAM-1)与脑梗死患者颈动脉粥样硬化(CAS)的关系。方法选取2021年6月至2024年6月榆林市第一医院收治的180例急性脑梗死(ACI)患者作为研究对象,根据颈动脉超声颈动脉内中膜厚度情况将ACI患者分为斑块形成组(n=70)、内膜增厚组(n=58)、内膜正常组(n=52),分析其临床资料;另选取同期入院健康体检者120人作为对照组,比较ACI患者与对照组MES检出率和血清LP-PLA2、VCAM-1水平,分析血清LP-PLA2、VCAM-1水平与临床资料的相关性,采用logistic回归分析ACI患者CAS斑块形成的影响因素,采用受试者工作特征(ROC)曲线分析MES、LP-PLA2、VCAM-1对CAS斑块形成的诊断价值。结果斑块形成组、内膜增厚组、内膜正常组之间总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)比较差异具有统计学意义(P<0.05);ACI组MES检出率、血清LP-PLA2、VCAM-1水平均高于对照组(P<0.05),斑块形成组、内膜增厚组、内膜正常组之间MES检出率、血清LP-PLA2、VCAM-1水平比较差异显著(P<0.05);Pearson相关性分析显示,LP-PLA2、VCAM-1与TC、TG、LDL-C呈显著正相关(P<0.05),与HDL-C呈负相关(P<0.05);二元logistic回归分析显示,HDL-C、LDL-C、MES检出率、血清LP-PLA2、VCAM-1水平与ACI患者CAS斑块形成有关(P<0.05);以MES检出率、血清LP-PLA2、VCAM-1水平为检验变量,ROC曲线分析结果显示,MES、LP-PLA2、VCAM-1及三者联合检测对CAS斑块诊断的ROC曲线下面积分别为0.806、0.797、0.783、0.921,敏感度分别为85.71%、81.43%、77.14%\94.29%,联合检测敏感度均高于单项指标。结论MES、LP-PLA2、VCAM-1是CAS形成的影响因素,联合检测可用于辅助诊断ACI患者的CAS形成。
Objective To analyze the relationship between detection rate of microembolic signal(MES),serum lipoprotein-associated phospholipase A2(LP-PLA2),vascular cell adhesion molecule-1(VCAM-1)and carotid atherosclerosis(CAS)in patients with cerebral infarction.Methods 180 patients with acute cerebral infarction(ACI)admitted to the First Hospital of Yulin from June 2021 to June 2024 were selected as the research subjects.According to the carotid intima-media thickness of carotid ultrasound,they were divided into plaque formation group(n=70),intima thickening group(n=58)and normal intima group(n=52),and their clinical data were analyzed.120 healthy people admitted to the hospital for physical examination during the same period were included as the control group.The detection rate of MES and levels of serum LP-PLA2 and VCAM-1 were compared between ACI patients and the control group.The correlation between serum LP-PLA2 and VCAM-1 levels and clinical data was analyzed.Logistic regression analysis was used to analyze the influencing factors of CAS plaque formation in ACI patients.ROC curve was used to analyze the diagnostic value of MES,LP-PLA2 and VCAM-1 on CAS plaque formation.Results There were statistical differences in TC,TG,HDL-C and LDL-C among plaque formation group,intima thickening group and normal intima group(P<0.05).The detection rate of MES and levels of serum LP-PLA2 and VCAM-1 in ACI group were higher than those in control group(P<0.05),and significant differences were observed in the detection rate of MES,serum LP-PLA2 and VCAM-1 among plaque formation group,intima thickening group and normal intima group(P<0.05).Pearson correlation analysis suggested that LP-PLA2 and VCAM-1 were positively correlated with TC,TG and LDL-C(P<0.05),and were negatively correlated with HDL-C(P<0.05).Binary logistic regression analysis showed that HDL-C,LDL-C,MES detection rate,serum LP-PLA2 and VCAM-1 were related to CAS plaque formation in ACI patients(P<0.05).The detection rate of MES,serum LP-PLA2 and VCAM-1 were used as test variables,and ROC curve results revealed that the areas under the ROC curves of MES,LP-PLA2,VCAM-1 and combined detection for CAS plaque diagnosis were 0.806,0.797,0.783,and 0.921,and the sensitivities were 85.71%,81.43%,77.14%,and 94.29%respectively.The sensitivity of combined detection was higher than that of the single index.Conclusions MES,LP-PLA2 and VCAM-1 are the influencing factors of CAS formation,and combined detection can be used to assist the diagnosis of CAS formation in ACI patients.
作者
高巧林
封婷
张宏
乔子梅
梁佳佳
GAO Qiaolin;FENG Ting;ZHANG Hong;QIAO Zimei;LIANG Jiajia(Department of Neurology,The First Hospital of Yulin,Yulin,Shaanxi 719000,China)
出处
《中华神经外科疾病研究杂志》
2025年第2期55-60,共6页
Chinese Journal of Neurosurgical Disease Research
基金
陕西省自然科学基础研究计划项目(2021JQ-933)。
关键词
急性脑梗死
颈动脉粥样硬化
微栓子信号
脂蛋白相关磷脂酶A2
血管细胞粘附分子-1
Acute cerebral infarction
Carotid atherosclerosis
Microembolic signal
Lipoprotein-associated phospholipase A2
Vascular cell adhesion molecule-1
作者简介
高巧林,E-mail:gql100@163.com;通讯作者:梁佳佳,E-mail:543081368@qq.com。
