原发性高血压患者血清纤维蛋白胶凝素3水平与颈动脉粥样硬化的相关性研究
|
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.
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
[1]Fang L,Song J,Ma Z,et al.Prevalence and characteristics of hypertension in mainland Chinese adults over decades:a systematic review[J].J Hum Hypertens,2014,28(11):649-656.DOI:10.1038/jhh.2014.5.
[2]Wu D,Li C,Chen Y,et al.Influence of blood pressure variability on early carotid atherosclerosis in hypertension with and without diabetes[J].Medicine(Baltimore),2016,95(24):e3864.DOI:10.1097/MD.0000000000003864.
[3]Polak JF,Pencina MJ,O'Leary DH,et al.Common carotid artery intima-media thickness progression as a predictor of stroke in multi-ethnic study of atherosclerosis[J].Stroke,2011,42(11):3017-3021.DOI:10.1161/STROKEAHA.111.625186.
[4]Tattersall MC,Gassett A,Korcarz CE,et al.Predictors of carotid thickness and plaque progression during a decade:the Multi-Ethnic Study of Atherosclerosis[J].Stroke,2014,45(11):3257-3262.DOI:10.1161/STROKEAHA.114.005669.
[5]Polak JF,O'Leary DH.Carotid intima-media thickness as surrogate for and predictor of CVD[J].Glob Heart,2016,11(3):295-312.DOI:10.1016/j.gheart.2016.08.006.
[6]刘瑾,杨志健,鲁翔,等.汉族老年原发性高血压患者血浆同型半胱氨酸水平与下肢动脉粥样硬化的相关性研究[J].中华老年医学杂志,2018,37(8):837-841.DOI:10.3760/cma.j.issn.0254-9026.2018.08.001.
[7]Andrade FA,Beltrame MH,Bini VB,et al.Association of a new FCN3haplotype with high ficolin-3levels in leprosy[J].PLoS Negl Trop Dis,2017,11(2):e0005409.DOI:10.1371/journal.pntd.0005409.
[8]Prohászka Z,Munthe-Fog L,Ueland T,et al.Association of ficolin-3with severity and outcome of chronic heart failure[J].PLoS One,2013,8(4):e60976.DOI:10.1371/journal.pone.0060976.
[9]Geraci G,MulèG,Costanza G,et al.Relationship between carotid atherosclerosis and pulse pressure with renal hemodynamics in hypertensive patients[J].Am J Hypertens,2016,29(4):519-527.DOI:10.1093/ajh/hpv130.
[10]宁靓,王永生,杨波,等.老年隐性高血压患者血压变异性与颈动脉粥样硬化及尿微量白蛋白的相关性[J].中国老年学杂志,2015,35(1):86-87.DOI:10.3969/j.issn.1005-9202.2015.01.042.
[11]张贞,宁兴旺,匡敏,等.冠状动脉粥样硬化性心脏病患者血浆同型半胱氨酸水平检测研究的进展[J].中华检验医学杂志,2016,39(9):726-728.DOI:10.3760/cma.j.issn.1009-9158.2016.09.015.
[12]Zhao J,Chen H,Liu N,et al.Role of hyperhomocysteinemia and hyperuricemia in pathogenesis of atherosclerosis[J].JStroke Cerebrovasc Dis,2017,26(12):2695-2699.DOI:10.1016/j.jstrokecerebrovasdis.2016.10.012.
[13]Liu B,Chen Z,Dong X,et al.Association of prehypertension and hyperhomocysteinemia with subclinical atherosclerosis in asymptomatic Chinese:a cross-sectional study[J].BMJOpen,2018,8(3):e019829.DOI:10.1136/bmjopen-2017-019829.
[14]Liu H,Yao Y,Wang Y,et al.Association between high-sensitivity C-reactive protein,lipoprotein-associated phospholipase A2and carotid atherosclerosis:a cross-sectional study[J].JCell Mol Med,2018,22(10):5145-5150.DOI:10.1111/jcmm.13803.
[15]McCully KS.Homocysteine and the pathogenesis of atherosclerosis[J].Expert Rev Clin Pharmacol,2015,8(2):211-219.DOI:10.1586/17512433.2015.1010516.
[16]Zhang X,Hu Y,Shen J,et al.Low levels of ficolin-3are associated with diabetic peripheral neuropathy[J].Acta Diabetol,2016,53(2):295-302.DOI:10.1007/s00592-015-0780-6.
[17]Michalski M,'Swierzko AS,Sawicki S,et al.Interactions of ficolin-3with ovarian cancer cells[J].Immunobiology,2019,224(2):316-324.DOI:10.1016/j.imbio.2019.01.002.
[18]Yuan XS,Shi H,Wang HY,et al.Ficolin-3/adiponectin ratio for the prediction of gestational diabetes mellitus in pregnant women[J].J Diabetes Investig,2018,9(2):403-410.DOI:10.1111/jdi.12688.
[19]Pan JW,Gao XW,Jiang H,et al.Low serum ficolin-3levels are associated with severity and poor outcome in traumatic brain injury[J].J Neuroinflammation,2015,12:226.DOI:10.1186/s12974-015-0444-z.
[2]Wu D,Li C,Chen Y,et al.Influence of blood pressure variability on early carotid atherosclerosis in hypertension with and without diabetes[J].Medicine(Baltimore),2016,95(24):e3864.DOI:10.1097/MD.0000000000003864.
[3]Polak JF,Pencina MJ,O'Leary DH,et al.Common carotid artery intima-media thickness progression as a predictor of stroke in multi-ethnic study of atherosclerosis[J].Stroke,2011,42(11):3017-3021.DOI:10.1161/STROKEAHA.111.625186.
[4]Tattersall MC,Gassett A,Korcarz CE,et al.Predictors of carotid thickness and plaque progression during a decade:the Multi-Ethnic Study of Atherosclerosis[J].Stroke,2014,45(11):3257-3262.DOI:10.1161/STROKEAHA.114.005669.
[5]Polak JF,O'Leary DH.Carotid intima-media thickness as surrogate for and predictor of CVD[J].Glob Heart,2016,11(3):295-312.DOI:10.1016/j.gheart.2016.08.006.
[6]刘瑾,杨志健,鲁翔,等.汉族老年原发性高血压患者血浆同型半胱氨酸水平与下肢动脉粥样硬化的相关性研究[J].中华老年医学杂志,2018,37(8):837-841.DOI:10.3760/cma.j.issn.0254-9026.2018.08.001.
[7]Andrade FA,Beltrame MH,Bini VB,et al.Association of a new FCN3haplotype with high ficolin-3levels in leprosy[J].PLoS Negl Trop Dis,2017,11(2):e0005409.DOI:10.1371/journal.pntd.0005409.
[8]Prohászka Z,Munthe-Fog L,Ueland T,et al.Association of ficolin-3with severity and outcome of chronic heart failure[J].PLoS One,2013,8(4):e60976.DOI:10.1371/journal.pone.0060976.
[9]Geraci G,MulèG,Costanza G,et al.Relationship between carotid atherosclerosis and pulse pressure with renal hemodynamics in hypertensive patients[J].Am J Hypertens,2016,29(4):519-527.DOI:10.1093/ajh/hpv130.
[10]宁靓,王永生,杨波,等.老年隐性高血压患者血压变异性与颈动脉粥样硬化及尿微量白蛋白的相关性[J].中国老年学杂志,2015,35(1):86-87.DOI:10.3969/j.issn.1005-9202.2015.01.042.
[11]张贞,宁兴旺,匡敏,等.冠状动脉粥样硬化性心脏病患者血浆同型半胱氨酸水平检测研究的进展[J].中华检验医学杂志,2016,39(9):726-728.DOI:10.3760/cma.j.issn.1009-9158.2016.09.015.
[12]Zhao J,Chen H,Liu N,et al.Role of hyperhomocysteinemia and hyperuricemia in pathogenesis of atherosclerosis[J].JStroke Cerebrovasc Dis,2017,26(12):2695-2699.DOI:10.1016/j.jstrokecerebrovasdis.2016.10.012.
[13]Liu B,Chen Z,Dong X,et al.Association of prehypertension and hyperhomocysteinemia with subclinical atherosclerosis in asymptomatic Chinese:a cross-sectional study[J].BMJOpen,2018,8(3):e019829.DOI:10.1136/bmjopen-2017-019829.
[14]Liu H,Yao Y,Wang Y,et al.Association between high-sensitivity C-reactive protein,lipoprotein-associated phospholipase A2and carotid atherosclerosis:a cross-sectional study[J].JCell Mol Med,2018,22(10):5145-5150.DOI:10.1111/jcmm.13803.
[15]McCully KS.Homocysteine and the pathogenesis of atherosclerosis[J].Expert Rev Clin Pharmacol,2015,8(2):211-219.DOI:10.1586/17512433.2015.1010516.
[16]Zhang X,Hu Y,Shen J,et al.Low levels of ficolin-3are associated with diabetic peripheral neuropathy[J].Acta Diabetol,2016,53(2):295-302.DOI:10.1007/s00592-015-0780-6.
[17]Michalski M,'Swierzko AS,Sawicki S,et al.Interactions of ficolin-3with ovarian cancer cells[J].Immunobiology,2019,224(2):316-324.DOI:10.1016/j.imbio.2019.01.002.
[18]Yuan XS,Shi H,Wang HY,et al.Ficolin-3/adiponectin ratio for the prediction of gestational diabetes mellitus in pregnant women[J].J Diabetes Investig,2018,9(2):403-410.DOI:10.1111/jdi.12688.
[19]Pan JW,Gao XW,Jiang H,et al.Low serum ficolin-3levels are associated with severity and poor outcome in traumatic brain injury[J].J Neuroinflammation,2015,12:226.DOI:10.1186/s12974-015-0444-z.