β2-微球蛋白与颈动脉斑块稳定性的相关性研究

Relationship betweenβ2-microglobulin and carotid plaque stability

目的 探讨β2-微球蛋白(β2M)与颈动脉粥样硬化斑块稳定性的相关性。方法 采用随机数字法筛选安徽省立医院神经内科门诊和住院患者中可能存在颈动脉硬化的风险人群共239例,按照排纳标准最终纳入123例作为研究对象。按照颈动脉彩超对颈动脉血管病变的评价标准将上述患者分为颈动脉内膜正常组(n=40)、斑块稳定组(n=43)、斑块不稳定组(n=40)。收集患者的一般临床资料、实验室指标,包括血清β2M、同型半胱氨酸(Hcy)、胱抑素C(CysC)等,以及颈动脉彩超检查结果。采用单因素分析比较3组数据一般临床资料和实验室指标之间的差异,采用多因素logistic回归分析β2M是否为颈动脉斑块不稳定性的独立危险因素,采用受试者工作特征(ROC)曲线分析血清中β2M水平预测颈动脉斑块不稳定性的价值。结果 单因素分析结果表明,年龄、性别、高血压病、糖尿病、β2M、Hcy、CysC、高密度脂蛋白胆固醇、肌酐在颈动脉内膜正常、稳定斑块、不稳定斑块组之间比较,差异具有统计学意义(P<0.05);二元logistic回归分析结果表明血清中β2M是颈动脉斑块不稳定性的独立危险因素,即血清中β2M水平越高,斑块不稳定性的发生率越大。ROC曲线结果表明血清中β2M水平为1.875 mg/L时能够较好地预测斑块的不稳定性。结论 血清中β2M水平是斑块不稳定性的独立影响因素。

Objective To explore the relationship betweenβ2-microglobulin(β2M)and the stability of carotid atherosclerotic plaques.Methods Using the random number method,239 individuals at risk for carotid atherosclerosis were screened from the outpatient and inpatient departments of neurology at Anhui Provincial Hospital.According to inclusion and exclusion criteria,123 patients were finally included as research subjects.Based on the evaluation standards of carotid vascular lesions from the ultrasound,the subjects were divided into three groups:a normal carotid intima group(n=40),a stable plaque group(n=43),and an unstable plaque group(n=40).Their general clinical data,laboratory indices such as serumβ2M,homocysteine(Hcy),cystatin C(CysC),and carotid ultrasound results were collected.Univariate analysis was conducted to compare differences in general clinical data and laboratory indices among the three groups.Multivariate logistic regression analysis was performed to determine whetherβ2M is an independent risk factor for carotid plaque instability.A receiver operating characteristic(ROC)curve was plotted to evaluate value of serumβ2M levels for predicting carotid plaque instability.Results Univariate analysis showed that age,gender,hypertension,diabetes,β2M,Hcy,CysC,high-density lipoprotein cholesterol,and creatinine were statistical different among the normal carotid intima group,stable plaque group,and unstable plaque group(P<0.05).Binary logistic regression analysis indicated that serumβ2M was an independent risk factor for carotid plaque instability;that is the higher the serumβ2M level,the greater the likelihood of plaque instability.The ROC curve analysis showed that a serumβ2M level of 1.875 mg/L could effectively predict plaque instability.Conclusions Serumβ2M levels are an independent factor influencing plaque instability.