[1]周世敏,曹 雷,孙 悦,等.外周血载脂蛋白A1、载脂蛋白B、脂蛋白(a)在颈动脉粥样硬化斑块易损性评价中的价值研究[J].陕西医学杂志,2023,52(11):1541-1545.[doi:DOI:10.3969/j.issn.1000-7377.2023.11.019]
　ZHOU Shimin,CAO Lei,SUN Yue,et al.Value of peripheral blood ApoA1,ApoB,LP(a)in evaluation of vulnerability of carotid atherosclerotic plaque[J].,2023,52(11):1541-1545.[doi:DOI:10.3969/j.issn.1000-7377.2023.11.019]
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外周血载脂蛋白A1、载脂蛋白B、脂蛋白(a)在颈动脉粥样硬化斑块易损性评价中的价值研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
52
期数:
2023年11期
页码:
1541-1545
栏目:
临床研究
出版日期:
2023-11-05

文章信息/Info

Title:
Value of peripheral blood ApoA1,ApoB,LP(a)in evaluation of vulnerability of carotid atherosclerotic plaque
作者:
周世敏; 曹 雷; 孙 悦; 丁 伟
(合肥市第八人民医院检验科,安徽 合肥238000)
Author(s):
ZHOU Shimin; CAO Lei; SUN Yue; DING Wei
(Department of Laboratory,the Eighth People's Hospital of Hefei,Hefei 238000,China)
关键词:
颈动脉粥样硬化斑块;  载脂蛋白A1;  载脂蛋白B;  脂蛋白(a);  易损性;  预测价值
Keywords:
Carotid atherosclerotic plaque;  Apolipoprotein A1;  Apolipoprotein B;  Lipoprotein(a);  Vulnerability;  Predictive value
分类号:
R 543.4
DOI:
DOI:10.3969/j.issn.1000-7377.2023.11.019
文献标志码:
A
摘要:
目的:分析外周血载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)、脂蛋白(a)[LP(a)]水平联合评价颈动脉粥样硬化斑块易损性的价值。方法:选取行超声检查具有颈动脉粥样硬化的156例患者为疾病组,根据超声造影检查结果将患者分为易损斑块组(76例)和非易损斑块组(80例),另同期选取本院150例健康体检者为对照组。检测并比较各组外周血ApoA1、ApoB、LP(a)水平,采用多因素Logistics多元回归分析法分析影响颈动脉粥样硬化斑块易损性的因素,并绘制受试者工作特征(ROC)曲线分析三者单独及联合检测对颈动脉粥样硬化斑块易损性的评估价值。结果:疾病组ApoA1水平低于对照组(P<0.05),ApoB、LP(a)水平高于对照组(均P<0.05); 易损斑块组ApoA1水平低于非易损斑块组(P<0.05),ApoB、LP(a)水平高于非易损斑块组(均P<0.05); 多因素Logistic回归分析结果显示有糖尿病史、尿酸(UA)≥447.34 μmol/L、C反应蛋白(CRP)≥13.52 mg/L、低密度脂蛋白(LDL)≥3.87 mmol/L、ApoA1<1.09 g/L、ApoB≥1.51 g/L、LP(a)≥283.04 mg/L均为颈动脉粥样硬化斑块易损性的独立危险因素(均P<0.05); ROC结果显示,ApoA1、ApoB、LP(a)三者联合评价颈动脉粥样硬化斑块易损性的灵敏度、特异度、曲线下面积(AUC)分别为93.42%、82.50%、0.925,联合评估的灵敏度高于单独评估(P<0.05),AUC高于单独评估(P<0.05),特异度与单独评估比较差异无统计学意义(P>0.05)。结论:ApoA1、ApoB、LP(a)均是颈动脉粥样硬化斑块易损性的影响因素,三者联合检测用来评估颈动脉粥样硬化斑块的易损性具有较大的价值。
Abstract:
Objective:To analyze the value of peripheral blood apolipoprotein A1(ApoA1),apolipoprotein B(ApoB),lipoprotein(a)[LP(a)]levels in joint evaluation of carotid atherosclerotic plaque vulnerability.Methods:A total of 156 patients with carotid atherosclerosis who underwent ultrasonography were selected as the disease group.According to the results of ultrasonography,the patients were divided into vulnerable plaque group(76 cases)and non-vulnerable plaque group(80 cases).During the same period,150 healthy subjects were selected as the control group.The levels of ApoA1,ApoB,and LP(a)in peripheral blood of each group were detected and compared.Multivariate Logistic regression was used to analyze the factors affecting the vulnerability of carotid atherosclerotic plaque,and the ROC curve was used to analyze the evaluation value of individual and combined detection on the vulnerability of carotid atherosclerotic plaque.Results:The ApoA1 level in the disease group was lower than that in the control group,and the ApoB and LP(a)levels were higher than those in the control group(all P<0.05).The ApoA1 level in the vulnerable plaque group was lower than that in the non-vulnerable plaque group,and the levels of ApoB and LP(a)were higher than those in the non-vulnerable plaque group(all P<0.05).Multivariate Logistic regression analysis showed that there was a history of diabetes,UA≥447.34 μmol/L,CRP≥13.52 mg/L,LDL≥3.87 mmol/L,ApoA1<1.09 g/L,ApoB≥1.51 g/L,LP(a)≥283.04 mg/L were independent risk factors for carotid atherosclerotic plaque vulnerability(all P<0.05).ROC results showed that the sensitivity,specificity,and area under the curve(AUC)of ApoA1,ApoB,and LP(a)in evaluating the vulnerability of carotid atherosclerotic plaque were 93.42%,82.50%,and 0.925,respectively,and the sensitivity of joint evaluation was higher than that of single evaluation(P<0.05),and the AUC was higher than that of single evaluation(P<0.05),and the specificity was not significantly different from that of single evaluation(P>0.05).Conclusion:ApoA1,ApoB,and LP(a)are all influencing factors of the vulnerability of carotid atherosclerotic plaque,and the combined detection of the three is of great value in evaluating the vulnerability of carotid atherosclerotic plaque.

参考文献/References:

[1] 吉 锋,李展绒,任耀龙,等.化痰通瘀除痹方治疗冠心病合并颈动脉粥样硬化斑块痰瘀困阻证疗效研究[J].陕西中医,2022,43(9):1212-1214.
[2] 桂明泰,曹 慧,钱 佳,等.加味越鞠丸对高血压患者颈动脉粥样硬化、血脂及炎性因子的影响[J].陕西中医,2022,43(2):181-184.
[3] 陈旭兰,吴小伟,蔡 伟.超声弹性成像技术评估急性脑梗死颈动脉粥样硬化斑块稳定性[J].武警医学,2020,31(5):426-429.
[4] Chen Y,Shang D,Shao J,et al.Prognostic significance of carotid plaque presence in peritoneal dialysis patients and its association with the apolipoprotein B/apolipoprotein A1 ratio[J].Nephrology(Carlton),2020,25(12):919-928.
[5] Han T,Paramsothy P,Hong J,et al.High-resolution MRI assessed carotid atherosclerotic plaque characteristics comparing men and women with elevated ApoB levels[J].Int J Cardiovasc Imaging,2020,36(3):481-489.
[6] Kaiser Y,Daghem M,Tzolos E,et al.Association of lipoprotein(a)with atherosclerotic plaque progression[J].J Am Coll Cardiol,2022,79(3):223-233.
[7] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国头颈部动脉粥样硬化诊治共识[J].中华神经科杂志,2017,50(8):572-578.
[8] 安 欣,曹 晋,王成凯.正常范围内游离甲状腺素水平与2型糖尿病患者颈动脉粥样硬化相关性探讨[J].陕西医学杂志,2021,50(8):958-961.
[9] 朱友义,高律萍,曹成瑛,等.高原地区汉、藏族冠状动脉与颈动脉及下肢动脉粥样硬化病变程度相关性及危险因素比较研究[J].陕西医学杂志,2023,52(4):404-407.
[10] 张劲草,耿 坡.检测血脂及血清ApoB/ApoA1比值对冠状动脉粥样硬化临床诊断意义[J].标记免疫分析与临床,2021,28(2):322-325.
[11] 赵月娥,吴才标,李育新,等.海南省黎族人群颈动脉粥样硬化斑块与血脂水平的相关性研究[J].中国医科大学学报,2020,49(1):58-61,66.
[12] Chang HC,Sung CW,Lin MH.Serum lipids and risk of atherosclerosis in xanthelasma palpebrarum:A systematic review and meta-analysis[J].J Am Acad Dermatol,2020,82(3):596-605.
[13] 郭明秋,殷晓捷,刁殿琰,等.脂质代谢水平与冠状动脉粥样硬化病变的关系[J].中国动脉硬化杂志,2021,29(2):149-155.
[14] Quispe R,Martin SS,Michos ED,et al.Remnant cholesterol predicts cardiovascular disease beyond LDL and ApoB:A primary prevention study[J].Eur Heart J,2021,42(42):4324-4332.
[15] 毛荷莲,侯万乐.急性脑梗死患者颈动脉粥样硬化斑块形成与血清脂蛋白a、MMP-9、D-D水平相关研究[J].标记免疫分析与临床,2021,28(7):1198-1201.
[16] 王琳琳,范 君,叶陈宇,等.血脂与老年冠心病患者颈动脉粥样硬化斑块的相关性[J].检验医学,2021,36(6):618-622.
[17] Vavuranakis MA,Jones SR,Cardoso R,et al.The role of lipoprotein(a)in cardiovascular disease:Current concepts and future perspectives[J].Hellenic J Cardiol,2020,61(6):398-403.
[18] 冯金艳,邱丽华.MRI检查对颈动脉粥样硬化斑块的诊断价值研究[J].陕西医学杂志,2019,48(4):467-469.
[19] Martinez E,Martorell J,Riambau V.Review of serum biomarkers in carotid atherosclerosis[J].J Vasc Surg,2020,71(1):329-341.
[20] Tsimikas S,Karwatowska-Prokopczuk E,Gouni-Berthold I,et al.Lipoprotein(a)reduction in persons with cardiovascular disease[J].N Engl J Med,2020,382(3):244-255.
[21] 杨蓬勃,黄桂玉,王 艳.血清ApoB/ApoA1比值对动脉粥样硬化临床诊断的价值[J].解放军医学院学报,2019,40(6):544-547.

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备注/Memo

备注/Memo:
基金项目:安徽省科技厅高校科学研究项目(KJ2020A0968)
更新日期/Last Update: 2023-11-06