摘要
目的探讨原发性高血压(EH)患者血清纤维蛋白胶凝素3(ficolin-3)水平与颈动脉粥样硬化相关性。方法横断面研究纳入我院心内科门诊及住院的老年EH患者386例分为EH 1级组100例,EH 2级组146例,EH 3级组140例,另选择同期健康体检者212例为对照组。所有患者接受颈动脉彩色超声,并进行颈动脉粥样硬化分级,采用ELISA检测血清ficolin-3水平。结果 4组血清ficolin-3水平比较有统计学差异(P<0.01),且EH 1级组、EH 2级组、EH 3级组血清ficolin-3水平呈显著降低趋势,差异有统计学意义(P<0.05)。颈动脉粥样硬化0级、1级、2级、3级、4级患者血清ficolin-3水平分别为(26.89±5.22)μg/L、(26.33±4.89)μg/L、(24.06±5.17)μg/L、(20.11±5.32)μg/L、(18.38±4.98)μg/L,血清ficolin-3水平呈显著降低趋势(P<0.05)。血清ficolin-3水平与颈动脉内膜中层厚度呈负相关(r=-0.398,P=0.003),是颈动脉粥样硬化的独立危险因素(P=0.001)。ficolin-3水平预测动脉粥样硬化发生的最佳切点为20.31μg/L,ROC曲线下面积为0.614(95%CI:0.553~0.675)。结论血清ficolin-3水平是EH患者颈动脉粥样硬化的独立危险因素,并具有一定预测价值。
Objective To study the relationship between serum ficolin-3 level and carotid atherosclerosis in EH patients.Methods Three hundred and eighty-six old EH patients admitted to our hospital were divided into EH 1 group(n=100),EH 2 group(n=146)and EH 3 group(n=140)with 212 age-matched healthy volunteers who underwent physical examination in our hospital served as a control group.The patients underwent color carotid ultrasonography and carotid atherosclerosis grading.Their serum ficolin-3 level was measured by ELISA.Results The serum level of ficolin-3 was significantly higher in control group than in 3 EH groups(P<0.05,P<0.01)while the serum ficolin-3 level was significantly lower in 3 EH groups than in control group(P<0.05).The average serum ficolin-3 level was 26.89±5.22μg/L,26.33±4.89μg/L,24.06±5.17μg/L,20.11±5.32μg/L and 18.38±4.98μg/L respectively in grades 0-4 carotid atherosclerosis patients and decreased with the severity of carotid atherosclerosis(P<0.05).The serum ficolin-3 level was negatively related with the carotid IMT(P=0.003),and was an independent risk factor for carotid atherosclerosis(P=0.001).The optimal serum ficolin-3 level for predicting carotid atherosclerosis was 20.31μg/L.The area under the ROC curve for carotid atherosclerosis was 0.614.Conclusion Serum ficolin-3 level is an independent risk factor for carotid atherosclerosis and can thus play a role in predicting carotid atherosclerosis in EH patients.
引文
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