老年急性脑梗死患者Hcy ApoB/ApoAⅠ及动态动脉硬化指数与颈动脉斑块性质的关系分析OACSTPCD
Relationship between Hcy ApoB/ApoAⅠand Ambulatory Arterial Stiffness Index and Carotid Plaque Properties in Elderly Patients with Acute Cerebral Infarction
目的:观察老年急性脑梗死(ACI)患者同型半胱氨酸(Hcy)、载脂蛋白B(ApoB)/载脂蛋白AⅠ(ApoAⅠ)及动态动脉硬化指数(AASI)的变化与颈动脉斑块性质的关系.方法:纳入 2021 年 7月至2023 年7 月本院收治的老年 ACI 患者 103 例(稳定性斑块 61 例,不稳定斑块 42 例),观察患者Hcy、ApoB/ApoAⅠ及AASI水平,采用单因素分析和多因素Logistic 回归分析 Hcy、ApoB、ApoAⅠ、AASI与颈动脉斑块性质的关系,并绘制受试者工作特征曲线(ROC)分析三指标对颈动脉斑块性质的评估效能.结果:不稳定斑块组Hcy、ApoB/ApoAⅠ、AASI水平及颈动脉中膜厚度(IMT)明显高于稳定斑块组,差异有统计学意义(P<0.05);Pearson 相关性显示:Hcy、ApoB/ApoAⅠ、AASI 水平与 IMT 成正相关,相关性有统计学意义(r=0.354、0.372、0.390,P<0.05);单因素分析显示:合并高血压、糖尿病、高脂血症与颈动脉斑块性质相关,差异有统计学意义(P<0.05);多因素Logistic回归分析显示:合并高血压、糖尿病、高脂血症及Hcy、ApoB/ApoAⅠ、AASI水平是影响颈动脉斑块性质的危险因素,差异有统计学意义(P<0.05);ROC 分析显示:Hcy、ApoB/ApoAⅠ、AASI 评估颈动脉斑块性质的 AUC 为 0.696、0.711、0.764,三指标联合评估的AUC最高为 0.853,最大约登指数下的敏感度和特异度分别为 0.952、0.607.结论:老年ACI患者Hcy、ApoB/ApoAⅠ、AASI水平变化与颈动脉斑块性质存在一定的关联,且对不稳定性斑块具有一定的评估价值.
Objective:To observe the relationship between changes of homocysteine(Hcy),apolipopro-tein B(ApoB)/apolipoprotein AⅠ(ApoAⅠ)and ambulatory arterial stiffness index(AASI)and carotid plaque properties in elderly patients with acute cerebral infarction(ACI).Methods:A total of 103 elderly patients with ACI(61 cases of stable plaque and 42 cases of unstable plaque)admitted to hospital from July 2021 to July 2023 were included.The Hcy,ApoB/ApoAⅠand AASI were observed.The relationship be-tween Hcy,ApoB,ApoAⅠ,AASI and carotid plaque properties was analyzed by univariate analysis and mul-tivariate Logistic regression analysis,and receiver operating characteristic curve(ROC)was plotted to analyze the evaluated efficiency of the three indicators on carotid plaque properties.Results:The Hcy,ApoB/ApoAⅠ,AASI and carotid intima-media thickness(IMT)in unstable plaque group were significantly higher than those in stable plaque group(P<0.05).Pearson correlation showed that Hcy,ApoB/ApoAⅠand AASI were positively correlated with IMT,showing statistical significance(r=0.354,0.372,0.390,P<0.05).Univa-riate analysis suggested that hypertension,diabetes mellitus and hyperlipidemia were related to the carotid plaque properties(P<0.05).Multivariate Logistic regression analysis revealed that hypertension,diabetes mellitus,hyperlipidemia,Hcy,ApoB/ApoAⅠ,and AASI were risk factors affecting the carotid plaque prop-erties(P<0.05).ROC analysis showed that the AUCs of Hcy,ApoB/ApoAⅠ and AASI in evaluating the carotid plaque properties were 0.696,0.711 and 0.764 respectively.The AUC of the combined evaluation of the three indicators was the highest(0.853),and the sensitivity and specificity under the maximum Youden index were 0.952 and 0.607 respectively.Conclusion:The changes of Hcy,ApoB/ApoAⅠ and AASI in elderly patients with ACI are related to the carotid plaque properties,and have certain evaluated value on un-stable plaque.
王国珍;郝井兰;张成刚
安徽省滁州市第一人民医院神经内科,安徽 滁州 239000
急性脑梗死颈动脉斑块同型半胱氨酸动脉硬化指数载脂蛋白B载脂蛋白AⅠ
Acute cerebral infarctionCarotid plaqueHomocysteineArterial stiffness indexApolipoprotein BApolipoprotein AⅠ
《河北医学》 2024 (011)
1839-1844 / 6
2022年安徽省重点研究与开发计划项目,(编号:2022e07020001)
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