血清PECAM-1、Sirt1水平与颈动脉粥样硬化斑块稳定性的关系

Relationships between serum PECAM-1 and Sirt1 levels and stability of carotid atherosclerotic plaque

目的探讨血清血小板内皮细胞黏附分子-1(PECAM-1)、沉默交配型信息调节因子2同源蛋白1(Sirt1)水平与颈动脉粥样硬化斑块(CAP)稳定性的关系。方法选取148例CAP患者,根据CAP稳定性分为不稳定组(n=81)和稳定组(n=67)。收集患者一般资料,酶联免疫吸附法测定血清PECAM-1、Sirt1,多因素Logistic回归分析CAP不稳定的影响因素,受试者工作特征(ROC)曲线分析血清PECAM-1、Sirt1水平对CAP不稳定的预测价值。结果不稳定组血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、PECAM-1水平高于稳定组,高密度脂蛋白胆固醇(HDL-C)、Sirt1水平低于稳定组(P均<0.05)。LDL-C(OR=1.675,95%CI:1.190~2.356)、PECAM-1(OR=1.622,95%CI:1.291~2.039)为CAP不稳定的独立危险因素,Sirt1(OR=0.438,95%CI:0.301~0.638)为独立保护因素(P均<0.05)。PECAM-1+Sirt1预测CAP不稳定的曲线下面积明显大于PECAM-1、Sirt1单独预测(P均<0.05),敏感度、特异度为88.89%、88.06%。结论CAP不稳定患者血清PECAM-1水平升高,Sirt1水平降低;血清PECAM-1、Sirt1水平为CAP不稳定独立影响因素,联合检测能提升CAP不稳定预测价值。

Objective To investigate the relationships between serum platelet endothelial cell adhesion molecule-1(PECAM-1)and silent mating-type information regulation 2 homolog 1(Sirt1)levels and the stability of carotid atherosclerotic plaque(CAP).Methods A total of 148 patients with CAP were selected,and then were divided into the unstable group(n=81)and stable group(n=67)based on CAP stability.We collected general information about the patients.The enzyme-linked immunosorbent assay was used to determine the serum PECAM-1 and Sirt1 levels,multifactor Logistic regression analysis was used to analyze the factors influencing CAP instability,and receiver operating characteristics(ROC)curve was used to analyze the value of serum PECAM-1 and SIRT1 levels in predicting CAP instability.Results Serum total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C)and PECAM-1 levels were significantly higher,but high-density lipoprotein cholesterol(HDL-C)and Sirt1 levels were significantly lower in the unstable group than in the stable group(all P<0.05).High LDL-C(OR=1.675,95%CI:1.190 to 2.356),PECAM-1(OR=1.622,95%CI:1.291 to 2.039)were independent risk factors for CAP instability,and high Sirt1(OR=0.438,95%CI:0.301 to 0.638)was an independent protective factor(all P<0.05).The area under curve(AUC)of PECAM-1+Sirt1 in predicting CAP instability was significantly greater than that predicted by PECAM-1 or Sirt1 alone(both P<0.05),and the sensitivity and specificity were 88.89%and 88.06%,respectively.Conclusion Serum PECAM-1 levels increase and Sirt1 levels decrease in patients with unstable CAP;serum PECAM-1 and Sirt1 are independent risk factors for CAP instability,and the combined detection of them can enhance the predictive value for CAP instability.