急性脑缺血患者血清IGFBP-4和PLGF水平与颈动脉斑块不稳定性的相关性研究

Correlation between the Levels of IGFBP-4,PlGF in Serum and Carotid Plaque Instability in Patients with Acute Cerebral Ischemia

目的探讨急性脑缺血(acute cerebral ischemia,ACI)患者血清胰岛素样生长因子结合蛋白-4(insulin like growth factor binding protein-4,IGFBP-4)和胎盘生长因子(placental growth factor,PLGF)水平的变化与颈动脉斑块不稳定性的相关性。方法收集2018年6月~2020年6月在商洛市中心医院和咸阳市第一人民医院神经内科住院治疗的105例颈动脉斑块患者作为研究对象。依据患者是否发生ACI分为ACI组(57例)和非ACI组(48例)。采用酶联免疫吸附法检测血清IGFBP-4和PLGF水平。所有研究对象均接受颈动脉超声造影检查。观察患者的斑块厚度、长度、剪切波速度(shear wave velocity,SWV)及回声强度(echo intensity,EI)。比较分析以上指标的变化与颈动脉斑块不稳定性的相关性。结果非ACI组和ACI组的血清IGFBP-4和PLGF水平分别为5.39±1.43ng/ml,7.27±1.83ng/ml和51.09±3.66ng/L,83.21±7.97ng/L。与非ACI组比较,ACI组的IGFBP-4和PLGF水平显著增高,差异有统计学意义(t=10.210~27.237,均P=0.000)。相关性分析显示,ACI组和非ACI组的血清IGFBP-4和PLGF水平分别呈正相关性(r=0.796,0.750,均P<0.01)。非ACI组的IGFBP-4和PLGF水平分别与SWV呈负相关性,与EI呈正相关性(rIGFBP-4=-0.823,0.835,均P<0.01;rPLGF=-0.794,0.812,均P<0.01)。ACI组的IGFBP-4和PLGF水平分别与SWV呈负相关性,与EI呈正相关性(rIGFBP-4=-0.833,0.851,均P<0.01;rPLGF=-0.819,0.827,P均<0.01)。结论IGFBP-4和PLGF可能参与颈动脉斑块破裂的病理过程。检测血清IGFBP-4和PLGF水平可对患者颈动脉斑块的不稳定性进行评估进而预测ACI的发生。

Objective To investigate the relationship between the changes of serum insulin-like growth factor binding protein-4(IGFBP-4)as well as placental growth factor(PlGF)levels and carotid plaque instability in patients with acute cerebral ischemia.Methods 105 patients with carotid plaque who were hospitalized in the Department of Neurology of the Central Hospital of Shangluo City and the First People’s Hospital of Xianyang City between June 2018 and June 2020 were selected as the research objects.According to whether the patients had the acute cerebral ischemia(ACI),they were divided into ACI group(57 cases)and non ACI group(48 cases).The serum levels of IGFBP-4 and PlGF were detected by enzyme-linked immunosorbent assay.All subjects underwent carotid ultrasound contrast-enhanced examination.The plaque thickness,length,shear wave velocity(SWV)and echo intensity(EI)were observed.The correlation between the changes of the above indexes and the carotid plaque instability was compared and analyzed.Results The serum levels of IGFBP-4 and PlGF in non ACI group and ACI group were(5.39±1.43,7.27±1.83)ng/ml and(51.09±3.66,83.21±7.97)ng/L,respectively.Compared with non ACI group,the serum levels of IGFBP-4 and PlGF in ACI group were significantly higher,the difference were statistically significant(t=10.210,27.237,P=0.000).There was a positive correlation between serum IGFBP-4 and PlGF levels in ACI group and non ACI group(r=0.796,0.750,all P<0.01).The levels of IGFBP-4 and PlGF in non ACI group were negatively correlated with SWV and were positively correlated with EI(rIGFBP-4=-0.823,0.835,all P<0.01;rPLGF=-0.794,0.812,all P<0.01).The levels of IGFBP-4 and PlGF in ACI group were negatively correlated with SWV and were positively correlated with EI(rIGFBP-4=-0.833,0.851,all P<0.01;rPLGF=-0.819,0.827,all P<0.01).Conclusion IGFBP-4 and PlGF may be involved in the pathological process of carotid plaque rupture.Detection of serum IGFBP-4 and PlGF levels can evaluate the carotid plaque instability and predict the occurrence of ACI.