外周血红细胞微粒及内皮细胞微粒水平与颈动脉粥样硬化斑块易损性的关系

Relation of peripheral blood red blood cell microparticles and endothelial microparticles levels with carotid atherosclerotic plaque vulnerability

目的探讨外周血红细胞微粒(RMPs)及内皮细胞微粒(EMPs)水平与颈动脉粥样硬化斑块易损性的关系。方法收集227例单侧颈动脉粥样硬化性狭窄患者的临床资料,根据颈动脉超声造影结果将患者分为稳定斑块组(71例)和易损斑块组(156例)。比较两组患者的一般资料及外周血RMPs、EMPs水平。采用多因素Logistic回归模型分析影响颈动脉易损斑块形成的危险因素。分析外周血RMPs、EMPs水平与颈动脉狭窄率及颈动脉超声造影分级的相关性。采用受试者工作特征(ROC)曲线分析外周血RMPs、EMPs水平评估颈动脉易损斑块形成的效能。结果易损斑块组男性比例、年龄、收缩压、舒张压、外周血RMPs和EMPs水平均大于或高于稳定斑块组(均P<0.05)。男性是颈动脉易损斑块形成的危险因素(P<0.05)。颈动脉粥样硬化性狭窄患者的外周血RMPs、EMPs水平与颈动脉狭窄率及颈动脉超声造影分级均呈正相关(均P<0.05)。ROC曲线结果显示,外周血RMPs和EMPs水平评估颈动脉易损斑块形成的曲线下面积(AUC)分别为0.827和0.836;两者联合评估的AUC为0.903,均高于单一指标的AUC。结论与存在稳定斑块的患者相比,存在易损斑块的颈动脉粥样硬化性狭窄患者外周血RMPs及EMPs水平更高,其与患者颈动脉狭窄程度及颈动脉粥样硬化斑块易损性呈正相关,联合检测外周血RMPs及EMPs水平在评估颈动脉易损斑块形成中具有一定的临床价值。

Objective To investigate the relation of peripheral blood red blood cell microparticles(RMPs)and endothelial microparticles(EMPs)levels with carotid atherosclerotic plaque vulnerability.Methods The clinical data of 227 patients with unilateral carotid atherosclerotic stenosis were collected,and patients were divided into stable plaque group(71 cases)or vulnerable plaque group(156 cases)according to the results of carotid contrast-enhanced ultrasound.The general data and levels of peripheral blood RMPs and EMPs were compared between patients of the two groups.The multivariate Logistic regression model was used to analyze the risk factors affecting the formation of carotid artery vulnerable plaque.The correlation of peripheral blood RMPs and EMPs levels with carotid artery stenosis rate and carotid contrast-enhanced ultrasound grade was analyzed.The efficiency of peripheral blood RMPs and EMPs levels for evaluating the formation of carotid artery vulnerable plaque was analyzed by using receiver operating characteristic(ROC)curve.Results The vulnerable plaque group exhibited a larger male proportion,and older age,as well as higher systolic pressure,diastolic pressure,peripheral blood RMPs and EMPs levels as compared with the stable plaque group(all P<0.05).Male was the risk factor for the formation of carotid artery vulnerable plaque(P<0.05).Peripheral blood RMPs and EMPs levels positively correlated with carotid artery stenosis rate and carotid contrast-enhanced ultrasound grade of patients with carotid atherosclerotic stenosis(all P<0.05).The results of ROC curve revealed that the areas under the curve(AUC)of peripheral blood RMPs and EMPs levels for evaluating the formation of carotid artery vulnerable plaque were 0.827 and 0.836;furthermore,the AUC of the combination of the two for evaluation was 0.903,which was higher than AUC of the single indicator.Conclusion Compared with patients with stable plaque,the peripheral blood RMPs and EMPs levels in carotid atherosclerotic stenosis patients with vulnerable plaques are higher,which positively correlate with the carotid artery stenosis degree and carotid atherosclerotic plaque vulnerability of patients.The combined detection of peripheral blood RMPs and EMPs levels exerts clinical values for evaluating the formation of carotid artery vulnerable plaque to a certain extent.