缺血性卒中患者血清磷脂转运蛋白活性与颈动脉内-中膜厚度的相关性研究

Correlation of serum phospholipid transfer protein activity and carotid intra-media thickness in patients with ischemic stroke

目的:探讨缺血性卒中患者血清磷脂转运蛋白(PLTP)活性与颈动脉内-中膜厚度(CIMT)的相关性。方法:收集2019年1月至2019年12月,于咸阳市第一人民医院神经内科治疗的226例缺血性卒中患者纳入研究,根据颈动脉超声测定结果分为CIMT正常组,CIMT增厚组和颈动脉斑块组,另选择60例CIMT正常的健康体检者作为对照组。检测血清PLTP活性及血脂水平。结果:CIMT正常组、CIMT增厚组和颈动脉斑块组血清PLTP活性水平均显著高于对照组,颈动脉斑块组明显高于CIMT正常组和CIMT增厚组,差异均具有统计学意义(均P<0.05)。Pearson直线相关分析结果显示,缺血性卒中患者血清PLTP活性水平与CIMT呈正相关关系(r=0.397,P<0.001)。多元线性回归分析结果示,血清PLTP活性水平是缺血性卒中患者CIMT的独立影响因素(Beta=0.436;P<0.001)。ROC曲线分析结果显示缺血性卒中患者血清PLTP活性预测高四分位CIMT的曲线下面积为0.806(0.748,0.865),cut-off值为92.62 mg/dL,对应的敏感性和特异性分别为0.911和0.618。结论:缺血性卒中患者血清PLTP活性水平与CIMT呈正相关关系。

Objective:To investigate the relationship between serum activity levels of phospholipid transfer protein(PLTP)and carotid intra-media thickness(CIMT)in patients with ischemic stroke(IS).Methods:226 patients with IS who receiving carotid ultrasonography in our hospital from January 2019 to December 2019 were recruited in this study.These patients were divided into CIMT normal group,CIMT thickening group and carotid atherosclerotic plaque(CAP)group according to the result of carotid ultrasonography.Meanwhile,60 healthy volunteer also were selected into this study as control.PLTP activity and serum levels of lipid were measured.Results:Serum PLTP activity levels of the CIMT normal group,the CIMT thickening group and the CAP group were significantly higher than that of the control group.Serum PLTP activity levels of the CAP group was significantly higher than those of the CIMT normal group and the CIMT thickening group,with statistically significant differences(all P<0.05).Pearson correlation analysis showed that serum PLTP activity level was significantly positively related to CIMT(r=0.397,P<0.001).Multiple linear regression analysis showed that serum PLTP activity level was an independent factor affecting CIMT in patients with IS(Beta=0.436,P<0.001).Based on the ROC curve,the area under the ROC curve was 0.806(0.748,0.865)of serum PLTP activity in prediction of CIMT within highest quartile for IS pstients.The boundary value of serum PLTP activity was 92.62 mg/dl.The sensitivity and specificity of serum PLTP activity in prediction of CIMT within highest quartile were 91.1%and 61.8%,respectively.Conclusions:The serum level of PLTP activity is positively associated with CIMT in IS patients.