血清LRP6及CD36对脑梗死伴颈动脉不稳定斑块患者的意义

发布时间：2018-07-14 21:26

【摘要】：目的探讨低密度脂蛋白受体相关蛋白6(LRP6)、CD36与脑梗死伴颈动脉不稳定斑块的关系,以及其对脑梗死伴颈动脉不稳定斑块的诊断价值。方法选取经头颅CT或MRI及颈动脉彩超确诊的脑梗死伴颈动脉不稳定斑块患者50例作为脑梗死组,单纯颈动脉不稳定斑块患者50例作为不稳定斑块组,并同期选择体检中心无颈动脉斑块及脑梗死者50例作为对照组。测定研究对象血清LRP6、CD36及各生化指标水平。结果脑梗死组血清LRP6水平低于不稳定斑块组及对照组,CD36水平则高于不稳定斑块组及对照组;差异均有统计学意义(P0.05)。多元logistic回归分析显示CD36是脑梗死伴颈动脉不稳定斑块患者的危险因素(OR=3.360),LRP6是脑梗死伴颈动脉不稳定斑块患者的保护因素(OR=0.696)。相关性分析显示LRP6与低密度脂蛋白胆固醇(LDL-C)呈负相关(r=-0.470,-0.732,P0.01),CD36与LDL-C呈正相关(r=0.454,0.716,P0.01)。血清LRP6水平诊断脑梗死的ROC曲线下面积为0.867,最佳临界值为13.79 ng/m L,灵敏度为86.0%,特异度为94.0%;血清CD36水平诊断脑梗死的ROC曲线下面积为0.836,最佳临界值为5.11 ng/m L,灵敏度为88.0%,特异度为86.0%。结论 LRP6是脑梗死伴颈动脉不稳定斑块的保护因素,CD36是脑梗死伴颈动脉不稳定斑块的危险因素,血清LRP6、CD36可能是预测脑梗死的生物学指标。
[Abstract]:Objective to investigate the relationship between low density lipoprotein receptor associated protein 6 (LRP6) CD36 and cerebral infarction associated with carotid unstable plaque and its diagnostic value. Methods Fifty patients with cerebral infarction associated with unstable plaque of carotid artery were selected as cerebral infarction group and 50 patients with simple unstable plaque of carotid artery as unstable plaque group. At the same time, 50 cases without carotid plaque and cerebral infarction in physical examination center were selected as control group. The serum levels of LRP6 and CD36 and their biochemical indexes were measured. Results the level of serum LRP6 in cerebral infarction group was lower than that in unstable plaque group and control group, and the level of CD36 was higher than that in unstable plaque group and control group (P0.05). Multiple logistic regression analysis showed that CD36 was a risk factor (OR3.360) and LRP6 was a protective factor (OR0.696) in patients with cerebral infarction and carotid unstable plaque. Correlation analysis showed that there was a negative correlation between low density lipoprotein cholesterol (LDL-C) and low density lipoprotein cholesterol (LDL-C). The area under the ROC curve of serum LRP6 is 0.867, the best critical value is 13.79 ng/m L, the sensitivity is 86.0, the specificity is 94.0.The area under the curve of serum CD36 is 0.836, the best critical value is 5.11 ng/m L, the sensitivity is 88.0 and the specificity is 86.0. Conclusion LRP6 is a protective factor for cerebral infarction with carotid artery instability plaque. CD36 is a risk factor for cerebral infarction with carotid artery unstable plaque. Serum LRP6 CD36 may be a biological index to predict cerebral infarction.
【作者单位】：石河子大学医学院第一附属医院神经内科;
【分类号】：R743.33

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