中国动脉硬化杂志2025，Vol.33Issue(8)：702-708,7.DOI:10.20039/j.cnki.1007-3949.2025.08.008
血清UA/Cr、Hcy和ApoA1水平与颈动脉粥样硬化患者斑块稳定性的关系及对继发急性脑梗死的预测价值
The relationship between serum UA/Cr,Hcy and ApoA1 levels and plaque stability in patients with carotid atherosclerosis and the predictive value for secondary acute cere-bral infarction
摘要
Abstract
Aim To explore the relationship between serum uric acid(UA)/creatinine(Cr),homocysteine(Hcy),apolipoprotein A1(ApoA1)levels and plaque stability in patients with carotid atherosclerosis(CAS)and the pre-dictive value for secondary acute cerebral infarction(ACI).Methods 138 patients with CAS were selected as the re-search subjects and further divided into stable plaque group and unstable plaque group based on the stability of plaques.Heathy individuals undergoing physical examinations were selected as the control group.Enzyme cycling method was used to detect Hcy level,latex enhanced immunoturbidimetry method was used to detect ApoA1 level,uricase method was used to detect UA level,enzyme method was used to detect Cr level,and UA/Cr ratio was calculated.Baseline data and labo-ratory indicators in the no plaque group,stable plaque group and unstable plaque group were compared.The relationship between laboratory indicators and intima-media thickness(IMT)was analyzed using Spearman correlation analysis.Cox regression model was used for univariate and multivariate analysis of secondary ACI in patients with CAS,and ROC curve was used to evaluate the predictive value of serum UA/Cr,Hcy and ApoA1 levels for it.Results Among 138 patients with CAS,there were 74 cases in the stable plaque group and 64 cases in the unstable plaque group;there were 46 cases of secondary ACI.There were 42 cases in the control group.Compared with the control group,the stable plaque group and unstable plaque group had lower levels of serum ApoA1 and high density lipoprotein cholesterol(HDLC),and higher levels of serum UA/Cr,Hcy,low density lipoprotein cholesterol(LDLC)and IMT(P＜0.05).Spearman correlation analysis showed that IMT in the plaque group was positively correlated with serum UA/Cr and Hcy levels(r=0.535 and r=0.681,P＜0.05),and negatively correlated with ApoA1 levels(r=-0.594,P＜0.05).Cox regression analysis showed that un-stable plaques,high serum UA/Cr and Hey levels were risk factors for secondary ACI,while high serum ApoA1 levels were protective factors for secondary ACI(P＜0.05).ROC curve analysis showed that the sensitivity and specificity of combi-ning serum UA/Cr,Hcy and ApoA1 for predicting secondary ACI in the CAS patients were 85.45％and 82.67％,respec-tively,with an AUC of 0.920,which was higher than the individual diagnosis of UA/Cr,Hcy and ApoA1.Conclu-sions The levels of serum UA/Cr and Hcy are significantly positively correlated with plaque formation and stability in the CAS patients,while ApoA1 is significantly negatively correlated with them.These three factors are independent influen-cing factors for secondary ACI in the CAS patients,and their combined prediction of ACI has a higher efficacy.关键词
颈动脉粥样硬化/急性脑梗死/斑块稳定性/尿酸/肌酐比值/同型半胱氨酸/载脂蛋白A1Key words
carotid atherosclerosis/acute cerebral infarction/plaque stability/uric acid/creatinine ratio/homoeysteine/apo1ipoprotein A1分类
医药卫生引用本文复制引用
刘晨菲,王艳,马飞..血清UA/Cr、Hcy和ApoA1水平与颈动脉粥样硬化患者斑块稳定性的关系及对继发急性脑梗死的预测价值[J].中国动脉硬化杂志,2025,33(8):702-708,7.基金项目
邢台市重点研发计划自筹项目(2024ZC207) （2024ZC207）
