缺血性脑卒中患者血清dp-ucMGP、骨钙素水平与颈内动脉颅内段钙化的相关性

The correlation between serum dp-ucMGP,osteocalcin levels and intracranial calcification of the internal carotid artery in patients with ischemic stroke

目的探究缺血性脑卒中患者血清去磷酸化未羧化基质Gla蛋白(dp-ucMGP)、骨钙素(OC)水平与颈内动脉颅内段钙化的相关性。方法选取2020年12月—2022年10月河北省保定市第二医院神经内科收治的缺血性脑卒中患者172例为研究对象,以血管壁钙化评分分为无钙化组37例,轻度钙化组95例,重度钙化组40例。收集患者临床资料;检测患者血清生化指标及dp-ucMGP、OC水平;分析血清dp-ucMGP、OC水平与缺血性脑卒中患者年龄、吸烟史、25-羟基维生素D[25(OH)D]的相关性,Logistic回归分析影响缺血性脑卒中患者颈内动脉颅内段钙化的危险因素,受试者工作特征曲线(ROC)分析血清dp-ucMGP、OC水平对缺血性脑卒中患者颈内动脉颅内段轻度、重度钙化的预测价值。结果与无钙化组比较,轻度钙化组和重度钙化组患者年龄、吸烟史比例升高,25(OH)D水平降低(F=5.901、P=0.003,χ^(2)=8.963、P=0.011,F=33.403、P<0.001);与轻度钙化组比较,重度钙化组25(OH)D水平降低(P<0.05)。无钙化组、轻度钙化组、重度钙化组血清dp-ucMGP、OC水平依次升高(F/P=101.057/<0.001、11.668/<0.001)。血清dp-ucMGP水平与OC呈明显正相关(r/P=0.563/<0.001)。dp-ucMGP高水平、OC高水平是影响缺血性脑卒中患者颈内动脉颅内段钙化的危险因素[OR(95%CI)=2.329(1.510~3.591)、1.735(1.010~2.980)]。血清dp-ucMGP、OC水平及二者联合预测缺血性脑卒中患者颈内动脉颅内段轻度钙化的AUC分别为0.857、0.825、0.913,二者联合的AUC大于各自单独预测的AUC(Z/P=2.869/0.004、2.861/0.004)。血清dp-ucMGP、OC水平及二者联合预测缺血性脑卒中患者颈内动脉颅内段重度钙化的AUC分别为0.876、0.809、0.945,二者联合的AUC大于各自单独预测的AUC(Z/P=2.314/0.021、3.012/0.003)。结论缺血性脑卒中患者血清dp-ucMGP、OC水平随颈内动脉颅内段钙化程度的升高而升高,对颈内动脉颅内段钙化程度有一定预测价值。

Objective To explore the correlation between serum Dephosphorylation uncarboxylated matrix Gla protein(dp-ucMGP),osteocalcin(OC)levels and intracranial calcification of internal carotid artery in patients with ischemic stroke.Methods One hundred and seventy-two patients with ischemic stroke who were admitted to the Neurology,the Second Hospital of Baoding City,Hebei Province from December 2020 to October 2022 were selected as the research objects.The vascular wall calcification score was divided into 37 cases of no calcification group,95 cases of mild calcification group,and 40 cases of severe calcification group.Collect clinical data of patients;Detect serum biochemical indicators and levels of dp-ucMGP and OC in patients;Analyze the correlation between serum levels of dp-ucMGP and OC with age,smoking history,and 25-hydroxyvitamin D[25(OH)D]in patients with ischemic stroke.Logistic regression analysis is used to identify the risk factors for intracranial carotid artery calcification in patients with ischemic stroke.The receiver operating characteristic curve(ROC)is used to analyze the predictive value of serum levels of dp-ucMGP and OC for mild and severe intracranial carotid artery calcification in patients with ischemic stroke.Results Compared with the non calcification group,the mild calcification group and the severe calcification group showed an increase in age,smoking history,and a decrease in 25(OH)D levels(F=5.901,P=0.003,χ^(2)=8.963,P=0.011,F=33.403,P<0.001);Compared with the mild calcification group,the severe calcification group showed a decrease in 25(OH)D levels(P<0.05).The levels of serum dp-ucMGP and OC in the non calcification group,mild calcification group,and severe calcification group increased sequentially(F/P=101.057/<0.001,11.668/<0.001).The serum dp ucMGP level was significantly positively correlated with OC(r/P=0.563/<0.001).High levels of dp-ucMGP and OC are risk factors for intracranial carotid artery calcification in ischemic stroke patients[OR(95%CI)=2.329(1.510-3.591),1.735(1.010-2.980)].The serum levels of dp-ucMGP and OC,as well as their combined prediction of AUC for mild calcification in the intracranial segment of the internal carotid artery in patients with ischemic stroke,were 0.857,0.825,and 0.913,respectively.The combined AUC of the two was greater than the AUC predicted separately(Z/P=2.869/0.004,2.861/0.004).The serum levels of dp-ucMGP,OC,and their combined prediction of severe calcification in the intracranial segment of the internal carotid artery in patients with ischemic stroke were 0.876,0.809,and 0.945,respectively.The combined AUC of the two was greater than the AUC predicted separately(Z/P=2.314/0.021,3.012/0.003).Conclusion The serum levels of dp-ucMGP and OC in patients with ischemic stroke increase with the degree of calcification in the intracranial segment of the internal carotid artery,which has certain predictive value for the degree of calcification in the intracranial segment of the internal carotid artery.