5-脂氧合酶、同型半胱氨酸与颈动脉粥样硬化稳定性的关系研究

目的 研究血清5-脂氧合酶(5-LO)、同型半胱氨酸(Hcy)与颈动脉粥样硬化(CAS)斑块稳定性的关系.方法 收集云南省第三人民医院经颈动脉超声诊断为CAS的患者共176名,并根据颈动脉超声结果分为稳定斑块组及易损斑块组;另收集同期该院体检中心体检并经由颈动脉超声排除CAS的健康志愿者108名为对照组;检测各组5-LO、Hcy的血清水平,并进行比较探讨两者与CAS斑块稳定性的关系;通过Logistic回归分析探讨CAS的危险因素并通过绘制ROC曲线探讨5-LO、Hcy预测颈动脉粥样硬化斑块稳定性的意义.结果 5-LO、Hcy在易损斑块组均较稳定斑块组及对照组高,差异有统计学意义(P＜0.05);稳定斑块组Hcy水平较对照组高(P＜0.05),而5-LO水平与对照组比较差异无统计学意义(P＞0.05);Logistic回归分析发现5-LO、Hcy、糖尿病是CAS的危险因素(P＜0.05).ROC曲线提示以232.89 pg/mL水平为临界值,血清5-LO水平预测斑块稳定性的敏感性为84.4％,特异度为81.8％;以12.53 μmol/L为临界值,血清Hcy水平预测斑块稳定性的敏感性为70,1％,特异度为66.7％.结论 血清5-LO及Hcy是预测CAS斑块稳定性的危险因素;调节二者水平可能成为临床稳定CAS的潜在靶点.

Association study between serum level of 5-LO and Hcy and carotid atherosclerotic plaque stability

Objective To explore the correlation between 5-LO,Hcy and the stability of carotid artery arteriosclerosis (CAS).Methods A total of 176 patients diagnosis as CAS were assigned as study group then subdivided into stable plaques SP (group) and instable plaques IP(group).108 healthy volunteers were assigned as control group.The serum levels of 5-LO and Hcy were measured and the relationship between the two groups were analyzed.The risk factors of CAS were investigated by Logistic regression analysis and 5-LO and Hcy were used to predict the stability of carotid atherosclerotic plaque by drawing ROC curve.Results The levels of 5-LO and Hcy in the IP group were higher than those in the SP group and the control group(P＜0.05).The level of Hcy in SP group was higher than that in the control group (P＜0.05),while there is no statistical significance between SP and control group in the level of serum 5-LO(P＞0.05).Logistic regression analysis showed that 5-LO,Hcy and diabetes were the risk factors of CAS (P＜0.05).The ROC curve indicate that the optimal cut-off concentration of 5-LO was 232.89 pg/mL for discriminating the IP from SP,the sensibility and specificity were 84.4％ and 81.8％ respectively.And the optimal cut-off concentration of Hcy was 12.53 μmol/L and the sensibility and specificity were 70.1％ and 66.7％ respectively.Conclusion Serum 5-LO and Hcy are risk factors for predicting the stability of CAS plaques;regulating both levels may be a potential target for clinically stable CAS.