血液生化指标与颈动脉粥样硬化斑块稳定性的相关性研究

Association between blood biochemical parameters and carotid atherosclerotic plaque stability

目的评估血液生化指标与颈动脉粥样硬化斑块稳定性的相关性。方法选择在云南省第一人民医院颈动脉超声检查出颈动脉斑块患者191例,并分为不稳定斑块组102例和稳定斑块组89例,检测患者血生化指标,用logistic回归分析各指标与斑块稳定性的相关性。结果不稳定斑块组丙氨酸转氨酶、总胆红素、间接胆红素、白蛋白、TG、TC、HDL-C显著低于稳定斑块组,尿酸显著高于稳定斑块组(P<0.05,P<0.01)。logistic回归分析显示,丙氨酸转氨酶、白蛋白、HDL-C是不稳定性斑块的保护因素(P<0.05,P<0.01),尿酸(OR=1.02,95%CI:1.00~1.01,P=0.003)是不稳定性斑块的独立危险因素。高HDL-C患者不稳定斑块发生率显著低于低HDL-C患者(32.0%vs 56.6%,P=0.011);高尿酸血症患者不稳定斑块发生率显著高于无高尿酸血症者(63.4%vs 47.5%,P=0.028)。结论丙氨酸转氨酶,白蛋白,HDL-C和尿酸可能是老年人群不稳定性斑块的独立预测指标。

Objective To study the association between blood biochemical parameters and carotid atherosclerotic plaque stability.Methods One hundred and ninety-one patients with carotid atherosclerotic plaques detected by ultrasonography were divided into unstable carotid atherosclerotic plaque group(n=102)and stable carotid atherosclerotic plaque group(n=89).Their blood biochemical parameters were detected.The association between blood biochemical parameters and carotid atherosclerotic plaque stability was analyzed by logistic regression analysis.Results The serum levels of ALT,total bilirubin,indirect bilirubin,albumin,TG,TC and HDL-C were significantly lower while the serum level of UA was significantly higher in unstable carotid atherosclerotic plaque group than in stable carotid atherosclerotic plaque group(P<0.05,P<0.01).Logistic regression analysis showed that ALT,albumin and HDL-C were independent protective factors while UA was an independent risk factor for unstable carotid atherosclerotic plaques in the elderly(P<0.05,P<0.01).The incidence of unstable carotid atherosclerotic plaques was significantly lower in patients with a high serum HDL-C level than in those with a low serum HDL-C level(32.0%vs 56.6%,P=0.011)and were significantly higher in patients with a high serum UA level than in those with a low serum UA level(63.4%vs 47.5%,P=0.028).Conclusion ALT,albumin,HDL-C and UA are the independent predictors of unstable carotid atherosclerotic plaques in the elderly.