脂联素及内皮型一氧化氮合成酶与颈动脉斑块的关系

Correlation among adiponectin,endotheliocyte nitric oxide synthetase and carotid artery plaque

目的:探讨脂联素(APN)及内皮型一氧化氮合成酶(eNOS)水平与颈动脉斑块的关系。方法:300例接受颈动脉超声检查的住院患者,根据颈动脉粥样硬化斑块指数分为正常对照组(0级,70例)、斑块1级组(80例)、斑块2级组(80例)、斑块3级组(70例),根据斑块性质又分为软斑组(88例)和硬斑组(142例),观察各组APN水平及eNOS和内皮素-1(ET-1)的变化。结果:(1)与正常对照组比较,斑块2、3级组患者APN水平明显降低[(90.91±9.66)μg/ml比(52.87±11.12)μg/ml、(50.67±10.31)μg/ml],斑块1、2、3级组患者eNOS水平明显下降[(12.35±1.08)U/ml比(9.27±1.24)U/ml、(6.68±1.03)U/ml、(4.92±1.12)U/ml],ET-1水平明显升高[(100.25±4.46)ng/L比(152.46±5.12)ng/L、(164.87±4.58)ng/L、(206.47±5.09)ng/L],P<0.05～<0.01;Spearman线性相关分析表明APN水平与颈动脉软斑呈明显负相关(r=-0.83,P<0.05);(2)ROC曲线表明APN、eNOS指标对颈动脉有无斑块形成有预测价值(曲线下面积为0.674,0.681,P均<0.01)。结论:颈动脉粥样硬化斑块患者血脂联素、eNOS水平显著下降,对颈动脉斑块形成有预测价值。

Objective： To investigate correlation among adiponectin（APN）,endotheliocyte nitric oxide synthetase（eNOS）and carotid artery plaque.Methods：According to carotid atherosclerotic plaque index,a total of 300 inpatients undergoing carotid ultrasonography were divided into normal control group（n=70）,plaque stage 1 group（n=80）,plaque stage 2 group（n=80） and plaque stage 3 group（n=70）.According to characteristics of carotid artery plaques,the patients were divided into soft plaque group（n=88） and hard plaque group（n=142）.Changes of levels of APN,eNOS and endothelin（ET）-1 were observed in all groups.Results：（1） Compared with normal control group,there was significant decrease in APN level [（90.91±9.66） g/ml vs.（52.87±11.12） g/ml,（50.67±10.31） g/ml]in plaque stage 2 and 3 groups,significant decrease in eNOS level [（12.35±1.08） U/ml vs.（9.27±1.24） U/ml,（6.68±1.03） U/ml,（4.92±1.12） U/ml]and significant increase in ET-1 level [（100.25±4.46） ng/L vs.（152.46±5.12） ng/L,（164.87±4.58） ng/L,（206.47±5.09） ng/L]in plaque stage 1,2 and 3 groups,P0.05~0.01;Spearman linear correlation analysis showed that APN level was significant negatively correlated with soft plaque（r=-0.83,P0.05）;（2） ROC curve indicated that APN and eNOS may predict formation of carotid artery plaque [area under curve（AUC） = 0.674,0.681 respectively,P0.01 all].Conclusion： Levels of adiponectin and eNOS decrease in patients with carotid artery plaque,may predict formation of carotid artery plaque.