血清1-磷酸鞘氨醇水平对老年急性脑梗死患者颈动脉粥样硬化斑块形成有一定预测价值

梁栋.血清1-磷酸鞘氨醇水平对老年急性脑梗死患者颈动脉粥样硬化斑块形成有一定预测价值[J].内科急危重症杂志,2024,30(3):239-242

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DOI：10.11768/nkjwzzzz20240309

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基金项目:邢台市重点研发计划项目（2020ZC358）

作者	单位
梁栋	河北省退役军人总医院

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中文摘要:

摘要目的：探讨血清1-磷酸鞘氨醇（S1P）水平对老年急性脑梗死（ACI）患者颈动脉粥样硬化（CAS）斑块形成的预测价值。方法：采用横断面法选取入院24h内接受颈部血管超声检查的老年ACI患者223例，根据有无CAS斑块分为内膜增厚组（72例）和斑块组（151例），另选取同期健康体检者70例作为对照组。检测3组受试者血清S1P水平，采用单因素和多因素Logistic回归分析S1P与老年ACI患者CAS斑块形成的相关性，采用受试者工作特征（ROC）曲线分析S1P对颈动脉不稳定斑块的预测价值。结果：单因素分析显示，患者年龄、胆固醇（TC），甘油三酯（TG）、血清S1P水平与CAS斑块的形成有关（P均＜0.05）。斑块组S1P水平显著高于内膜增厚组 [(712.63±132.34) ng/mL vs. (656.86±130.58)ng/mL,P＜0.05]。多因素Logistic回归显示，S1P是影响CAS斑块形成的独立危险因素（OR>1，P<0.05）。ROC曲线显示，当S1P截断值为685ng/mL时，曲线下面积为0.97（95%CI：0.970~0.980，P=0.001），敏感度为95.8%，特异性为89.4%。结论：血清S1P水平是老年ACI患者CAS斑块形成的独立危险因素。

英文摘要:

Abstract Objective: To investigate the clinical value of serum sphingosine-1-phosphate (S1P) level in predicting carotid atherosclerotic plaque formation in elderly patients with acute cerebral infarction (ACI). Methods: Totally, 223 elderly patients with ACI who received cervical vascular ultrasound examination within 24h after admission and treated in our hospital were included by cross-sectional method. The enrolled patients were divided into endometrial thickening group (72 cases) and plaque group (151 cases) according to whether they had carotid atherosclerotic plaque. A total of 70 healthy subjects in our hospital during the same period were selected as the control group. Serum S1P levels of enrolled patients were detected, univariate analysis and multivariate Logistic regression were used to analyze the correlation between S1P and carotid atherosclerotic plaque formation in elderly patients with ACI, and receiver operating characteristic (ROC) curve was used to analyze the predictive value of S1P for carotid artery unstable plaque. Results: Univariate analysis showed that patients' age, total cholesterol (TC), triglyceride (TG) and S1P were associated with the formation of carotid atherosclerotic plaque, and the differences were statistically significant ( all P<0.05). The S1P level in the plaque group [(712.63±132.34) ng/mL] was significantly higher than that in the endometrial thickening group [(656.86±130.58) ng/mL] (P<0.05). Multivariate Logistic regression analysis showed that S1P was an independent risk factor for carotid atherosclerotic plaque formation (OR>1, P<0.05). When the S1P cut-off value was 685ng/mL, the area under ROC curve was 0.97 (95%CI: 0.970-0.980, P=0.001), the sensitivity was 95.8%, and the specificity was 89.4%. Conclusion: The serum S1P level is an independent risk factor for the formation of CAS plaques in elderly ACI patients.