血清CypA、ADAMTS-4水平与老年后循环脑梗死患者椎基底动脉斑块不稳定性的关系

Relationships between serum CypA and ADAMTS-4 levels and instability of vertebrobasilar artery plaque in elderly patients with posterior circulation cerebral infarction

目的探讨血清亲环素A(CypA)、含Ⅰ型血小板结合蛋白基序列的解聚蛋白样金属基质蛋白酶4(ADAMTS-4)水平与老年后循环脑梗死患者椎基底动脉斑块不稳定性的关系。方法选择老年后循环脑梗死患者142例,CT血管造影检查发现椎基底动脉存在不稳定性斑块86例(UP组)、稳定性斑块31例(SP组)、无斑块25例(NP组)。所有研究对象入院次日采集清晨空腹外周静脉血,离心留取血清,采用ELISA法检测血清CypA、ADAMTS-4。收集所有研究对象基线临床资料,采用多因素Logistic回归模型分析老年后循环脑梗死患者椎基底动脉斑块不稳定的危险因素。采用受试者工作特征(ROC)曲线分析血清CypA、ADAMTS-4水平对老年后循环脑梗死患者椎基底动脉斑块不稳定的预测价值。结果UP组血清CypA、ADAMTS-4水平均显著高于SP组和NP组,SP组血清CypA、ADAMTS-4水平均显著高于NP组(P均<0.05)。多因素Logistic回归分析显示,血糖、CypA、ADAMTS-4水平高是老年后循环脑梗死患者椎基底动脉斑块不稳定的独立危险因素(P均<0.05)。ROC曲线分析显示,血清CypA、ADAMTS-4水平单独和联合预测老年后循环脑梗死患者椎基底动脉斑块不稳定的曲线下面积分别为0.691、0.740、0.911,血清CypA、ADAMTS-4水平联合预测老年后循环脑梗死患者椎基底动脉斑块不稳定的曲线下面积显著高于血清CypA、ADAMTS-4水平单独(P均<0.05)。结论血清CypA、ADAMTS-4水平与老年后循环脑梗死患者椎基底动脉斑块不稳定密切相关,并可作为预测老年后循环脑梗死患者椎基底动脉斑块不稳定的生物学指标。

Objective To investigate the relationships between the levels of serum cyclophilin A(CypA),a disintegrin and metalloproteinase with thrombospondin motifs type 4(ADAMTS-4)and the instability of vertebrobasilar artery plaque in elderly patients with posterior circulation cerebral infarction.Methods Totally 142 elderly patients with posterior circulation cerebral infarction were selected.Eighty-six patients with unstable plaques(UP group),31 patients with stable plaques(SP group),and 25 patients without plaques(NP group)were found in vertebrobasilar artery by CT angiography.We collected the morning fasting peripheral venous blood from all the subjects the next day after admission,centrifuged the serum,and detected the serum CypA and ADAMTS-4 by ELISA.The baseline clinical data of all subjects were collected,and the risk factors of unstable vertebrobasilar artery plaque in elderly patients with posterior circulation cerebral infarction were analyzed by using multivariate Logistic regression model.The predictive value of serum CypA and AD-AMTS-4 levels on the instability of vertebrobasilar artery plaque in elderly patients with posterior circulation cerebral infarction was analyzed by ROC curve.Results The serum CypA and ADAMTS-4 levels in the UP group were significantly higher than those in the SP group and NP group,and the serum CypA and ADAMTS-4 levels in the SP group were significantly higher than those in the NP group(all P<0.05).Multivariate Logistic regression analysis showed that blood glucose,CypA and ADAMTS-4 were independent risk factors for unstable vertebrobasilar plaque in elderly patients with posterior circulation cerebral infarction(all P<0.05).ROC curve analysis showed that the area under the curve of serum CypA and ADAMTS-4 levels independently and jointly in predicting the instability of vertebrobasilar plaque in elderly patients with posterior circulation cerebral infarction was 0.691,0.740 and 0.911,respectively.The area under the curve of serum CypA and ADAMTS-4 levels jointly in predicting the instability of vertebrobasilar plaque in elderly patients with posterior circulation cerebral infarction was significantly higher than that of serum CypA and ADAMTS-4 levels alone(all P<0.05).Conclusion Serum CypA and ADAMTS-4 levels are closely related to the instability of vertebrobasilar artery plaque in elderly patients with posterior circulation cerebral infarction,and can be used as biological indicators to predict the instability of vertebrobasilar artery plaque in elderly patients with posterior circulation cerebral infarction.