血清淀粉样蛋白A与高龄患者颈动脉粥样硬化性狭窄相关性分析

To explore the correlation between serum amyloid protein A (SAA) and carotid atherosclerotic stenosis of in the aged patients

目的探讨血清淀粉样蛋白A(SAA)与高龄患者颈动脉粥样硬化性狭窄的相关性。方法收集广州市第一人民医院200例老年科80岁及以上住院病人的血管超声测定颈动脉狭窄、斑块形成、颈动脉内中膜(IMT)和SAA水平情况。根据患者SAA值分为正常组和异常组,分析SAA水平与颈动脉狭窄严重程度的关系。结果SAA异常组颈动脉血管狭窄程度及血管狭窄发生率高于正常组(Z=11.606,P=0.009和χ2=4.017,P=0.045),不稳定斑块发生率也高于正常组(χ2=8.031,P=0.008);通过Spearman相关性分析,发现颈动脉狭窄程度与SAA、D二聚体、超敏C反应蛋白、纤维蛋白原呈正相关,其相关系数分别为0.193(P=0.006)、0.150(P=0.047)、0.179(P=0.013)和0.166(P=0.028),SAA是高龄患者颈动脉狭窄的独立危险因素,其OR为0.886[95%CI=(1.114~5.277)]。结论SAA在80岁及以上高龄患者中,可能参与动脉粥样硬化全过程,可反映颈动脉斑块稳定性,且SAA水平升高与颈动脉狭窄程度相关。

Objective To explore the correlation between serum amyloid protein A(SAA)and carotid atherosclerotic stenosis in the aged old patients.Methods Totally 200 patients who were older than 80 years old that registered in Geriatric department of the First Affiliated Hospital of Guangzhou Medical University were enrolled in this study,vascular ultrasound were used to detect the stenosis of carotid artery,plaque formation,carotid intima-media thickness and SAA level.According to the SAA level,patients were classified to normal group and abnormal group.The relationship of SAA level and the severity of carotid artery were analyzed by Spearsman correlation analysis.Results SAA level abnormality was more related with severer and higher rates of occurrence of carotid artery stenosis(Z=11.606,P=0.009 andχ2=4.017,P=0.045,respectively).The results of Spearsman correlation analysis revealed that the severity of catotid artery stenosis was related to SAA level,hypersensitive C-reactive protein,D-dimer,fibrinogen,whose coefficients of correlation were 0.193(P=0.006)、0.150(P=0.047)、0.179(P=0.013)and 0.166(P=0.028),respectively.Conclusion Among elderly patients aged 80 and over,SAA may be involved in the whole process of atherosclerosis,which reflects the stability of artery plaque,and SAA level are also correlated with the degree of carotid atherosclerotic stenosis.