老年脑梗死患者血清血管生成素样蛋白8水平与颈动脉不稳定斑块的相关性研究

Relationship between serum ANGPTL8 level and carotid unstable plaques in elderly cerebral infraction patients

目的探讨老年脑梗死患者血清血管生成素样蛋白8((ANGPTL8))水平与颈动脉不稳定斑块的相关性。方法横断面连续纳入承德医学院附属医院神经内科发病72 h且接受颈部血管超声检查的老年脑梗死患者223例,依据颈部血管超声检查结果将受试者分为内膜增厚组73例、稳定斑块组55例、不稳定斑块组95例,另选取同期健康体检者70例为对照组。检测各组血清ANGPTL8水平,采用ROC曲线分析ANGPTL8对颈动脉不稳定斑块的预测价值。结果对照组、内膜增厚组、稳定斑块组、不稳定斑块组血清ANGPTL8分别为663.3(529.7,791.9)ng/L、1099.8(847.5,1337.3)ng/L、1925.6(1613.3,2300.6)ng/L、2901.5(2662.8,3125.9)ng/L,呈明显升高趋势,差异有统计学意义(P=0.000)。血清ANGPTL8与颈动脉内膜中层厚度呈正相关(r=0.902,P=0.001)。血清ANGPTL8为颈动脉不稳定斑块的独立危险因素(P=0.002)。血清ANGPTL8预测颈动脉不稳定斑块发生的最佳切点为2166.79 ng/L,ROC曲线下面积为0.97(95%CI:0.970~0.980,P=0.001)。结论血清ANGPTL8水平是老年脑梗死患者颈动脉不稳定斑块发生的独立危险因素,并且有一定的预测价值。

Objective To study the relationship between serum ANGPTL8 level and carotid unstable plaques in elderly cerebral infraction(CI)patients.Methods Two hundred and twenty-three elderly CI patients who underwent cervical vascular ultrasonograpgy in our hospital within 72 h after onset of CI were divided into carotid artery tunica intima thickness group(n=73),carotid artery stable plaque group(n=55)and carotid artery unstable plaque group(n=95)with 70 age-matched volunteers who underwent physical examination in our hospital served as a control group.Their serum ANGPTL8 level was measured.The value of serum ANGPTL8 level in predicting carotid artery unstable plaques was analyzed by ROC curve analysis.Results The serum ANGPTL8 level was significantly higher in carotid artery tunica intima thickness group,carotid artery stable plaque group and carotid artery unstable plaque group than in control group[1099.8(847.5,1337.3)ng/L,1925.6(1613.3,2300.6)ng/L,2901.5(2662.8,3125.9)ng/L vs 663.3(529.7,791.9 ng/L),P=0.000].The serum ANGPTL8 level was positively related with the carotid intima-meclia thickness(r=0.902,P=0.001)and was an independent risk factor for carotid unstable plaques(P=0.002).The optimal cut-off serum ANGPTL8 level was 2166.79 ng/L in predicting carotid unstable plaques.The area under the ROC curve for carotid unstable plaques was 0.97.Conclusion Serum ANGPTL8 level is an independent risk factor for carotid unstable plaques and can thus play a certain ro1 e in predicting carotid unstable plaques in elderly CI patients.