老年动脉粥样硬化不稳定斑块患者多种生化指标的变化及意义

目的通过对入选病例行氧化应激、炎症、免疫及血栓形成等方面的多种生化指标的检测,评价这些指标在老年动脉粥样硬化不稳定斑块患者中的变化情况及临床意义。方法选取105例经64层螺旋CT(64-MSCT)颈动脉成像确诊为颈动脉粥样硬化斑块的老年患者,根据CT结果分为稳定斑块组(55例)、不稳定斑块组(50例),分别测定血浆C反应蛋白(CRP)、丙二醛(MDA)、可溶性CD40配体(sCD40L)、同型半胱氨酸(HCY)、纤维蛋白原(FIB)水平。结果不稳定斑块组的CRP、MDA,sCD40L,FIB及HCY水平均显著高于稳定斑块组(P<0.05);不稳定斑块组与稳定斑块组的Logistic回归分析表明仅sCD40、CRP、吸烟是显著影响动脉粥样硬化不稳定斑块病变的因素(P<0.05)。结论血浆生化指标CRP、HCY、FIB、MDA、sCD40L水平的升高与老年动脉粥样硬化不稳定斑块病变显著相关,其中血浆高水平的CRP、sCD40L是影响不稳定斑块病变的独立因素,CRP及sCD40L水平的变化可能更能预测老年动脉粥样硬化不稳定斑块病变,尤其是特异性较高的sCD40L。

Research on the changes and meanings of multi- biochemical indexes in elderly patients with unstable atherosclerotic plaque lesion

Objective To investigate the changes and meanings of multi-biochemical indexes in oxidative stress,inflammation,immune and thrombosis in elderly patients with unstable atherosclerotic plaque.Methods According to the diagnosis by 64 multi-slice computerized tomography,105 patients were divided into stable plaque group(55 patients),unstable plaque group(50 patients).Plasma level of C-reactive protein(CRP),malondialdehyde(MDA),homocysteine(HCY),soluble CD40 ligand(sCD40L)and fibrinogen(FIB) were measured for each patients.Results Plasma levels of CRP,MDA,HCY,sCD40L,FIB in unstable atherosclerotic plaque group were significantly higher than those in stable plaque group(P< 0.05),Logistic regression showed that only CRP,sCD40,smoking were independently associated with unstable atherosclerotic plaque lesion.Conclusions There is a marked relationship between upregulation of CRP,MDA,sCD40L levels and unstable atherosclerotic plaque lesion.And plasma levels of CRP,sCD40L are associated with unstable plaques lesions,which could have great potential to predict unstable atherosclerotic plaque lesion.