摘要
目的研究颈动脉狭窄患者血浆含Ⅰ型血小板结合蛋白基序的解聚蛋白样金属蛋白酶4（ADAMTS4）的水平与颈动脉斑块稳定性的相关性，探讨ADAMTS4对颈动脉斑块稳定性评估的临床价值。方法60例颈动脉狭窄患者行颈动脉内膜剥脱术切除颈动脉斑块，切除标本依据病理学特点分为易损斑块组和稳定斑块组。30例颈动脉粥样硬化但无颈动脉斑块的患者为对照组。ELISA法测定血浆ADAMTS4水平。结果易损斑块组ADAMDS4水平（112．74±17．47）ng／ml较稳定斑块组（72．58±20．28）ng／ml及对照组（56．67±22．14）ng/ml明显增高，差异有统计学意义（P〈0．001）。Lostic分析显示血ADAMTS4水平高组与血ADAMTS4水平低组相比，斑块为易损斑块的概率更高（P〈0．05，OR=8．240，95％ CI：1．512～22．915）。ROC分析显示当血ADAMTS4=100．935ng/ml时，达到最大检测效能（AUC=94．3％）。结论ADAMTS4可作为评价颈动脉易损斑块的潜在血清标志物。
Objective To explore the relationship between the level of plasma ADAMTS4 and the vulnerability of carotid atherosclerotic plaque in patients with carotid artery stenosis and the clinical value of evaluating the vulnerability of the carotid atherosclerotic plaque. Methods 60 patients with carotid artery stenosis were divided into stable plaque group and vulnerable plaque group according to the bistopathological typing after carotid endarterectomy （CEA）. 30 patients who had atherosclerosis but no carotid plaque formation served as control. Using ELISA to measure the level of plasma ADAMTS4. Results The level of plasma ADAMTS4 was significantly higher in the vulnerable-plaque group （112.74 ± 17.47 ）ng/ml compared with the stable plaque group （56. 67 ± 22. 14 ）ng/ml and the control group （56. 67 ± 22. 14 ）ng/ ml, P 〈 0. 001. Logistic analysis showed that high level of plasma ADAMTS4 was risk factor for vulnerability of carotid atherosclerotic plaque（ P 〈 0. 05, OR = 8. 240,95% CI： 1. 512 - 22. 915 ）. ROC curve showed that ADAMTS4 = 100. 935 ng/ml could accurately predict significant vulnerability with accuracy of 94. 3%. Conclusion ADAMTS4 is an effective, sensitive and non-invasive biomarker to evaluate the vulnerability of carotid atherosclerotic plaque.
出处
《中华普通外科杂志》
CSCD
北大核心
2017年第12期1043-1046,共4页
Chinese Journal of General Surgery
