摘要
目的探讨急性脑梗死(Acute cerebral infarction,ACI)患者血清中CCL14表达水平与颈动脉斑块的相关性。方法GEO数据库下载颈动脉斑块组织及斑块旁组织中的基因表达数据集。GEO2R数据库在线分析颈动脉斑块组织中的差异表达基因。选择2022年8月-2023年1月于本医院神经内二科收治的104例ACI患者作为研究对象,作为ACI组;另选同期40名健康体检者作为对照组。ACI患者根据颈动脉超声检查结果,分为无斑块组(n=55)和斑块组(n=49),斑块组进一步分为稳定性斑块组(n=23)和不稳定性斑块组(n=26)两个亚组。所有研究对象血清中CCL14表达水平采用ELISA法检测。ACI患者血清中CCL14表达水平与颈动脉中膜厚度(Intima media thickness,IMT)和NIHSS评分的相关性采用Pearson法分析,Logistic回归分析探讨ACI患者颈动脉斑块形成的独立危险因素。ACI患者血清中CCL14表达水平诊断颈动脉斑块及不稳定性斑块的临床效能采用ROC曲线分析。结果与斑块旁组织相比,斑块组织中显著上调的基因共87个,显著下调的基因共60个。火山图,CCL14在斑块组织及斑块旁组织中的基因表达量分别为(0.78±0.12)和(0.34±0.10),与斑块旁组织相比,CCL14基因表达量在斑块组织中表达水平显著升高,差异具有统计学意义(P<0.05)。与对照组相比,CCL14表达水平在ACI组中显著升高[(34.55±3.45)pg/ml vs.(87.23±5.34)pg/ml,t=57.854,P<0.001]。无斑块组、稳定性斑块组、不稳定性斑块组血清中CCL14表达水平分别为(76.12±4.98)pg/ml、(82.88±5.17)pg/ml、(92.35±4.29)pg/ml,三组血清中CCL14表达水平比较存在显著差异(F=34.111,P<0.001),与无斑块组相比,稳定性斑块组和不稳定性斑块组血清中CCL14表达水平显著升高(P<0.05),与稳定性斑块组相比,不稳定性斑块组血清中CCL14表达水平显著升高(P<0.001)。与无斑块组相比,NIHSS评分、C反应蛋白、D-二聚体、梗死灶体积和CCL14表达水平在斑块组中显著升高,差异均具有统计学意义(P<0.05)。相关性分析结果证实,ACI患者血清中CCL14表达水平与IMT及NIHSS评分存在显著正相关性,相关系数r=0.456,r=0.781,P<0.05。C反应蛋白(OR=1.671)、D-二聚体(OR=2.115)及CCL14(OR=2.871)是ACI患者颈动脉斑块形成的独立危险因素。ROC曲线结果显示,血清中CCL14表达水平在诊断ACI患者颈动脉斑块的AUC为0.781,CCL14截断值为83.12 pg/ml,诊断敏感度和特异度分别为83.12%和86.87%;血清中CCL14表达水平在诊断ACI患者颈动脉不稳定性斑块形成的AUC为0.856,CCL14截断值为87.98 pg/ml,诊断敏感度和特异度分别为87.15%和90.44%。结论CCL14在ACI患者外周血中显著高表达,且CCL14可作为诊断ACI患者颈动脉斑块形成及不稳定性斑块的一项生物学标志物。
Objective To investigate the relationship between the serum expression of CCL14 and carotid artery plaque in patients with acute cerebral infarction(ACI).Methods The gene expression datasets of carotid plaque tissue and paracacular tissue was downloaded from GEO database.The GEO2R online database was used for exploring the differentially expressed genes in carotid plaque tissues.A total of 104 ACI patients(ACI group)who were admitted to second ward of neurology department in central hospital of Jiaozuo Coal Group during August 2022 and January 2023 were enrolled as study subjects,and another 40 people received healthy examination were enrolled in control group.According to the results of carotid artery ultrasonography,all ACI patients were divided into non-plaque group(n=55)and plaque group(n=49).The patients in plaque group were further divided into stable plaque group(n=23)and unstable plaque group(n=26),respectively.The serum expression level of CCL14 of all individuals was detected by ELISA method.The correlation between the serum expression level of CCL14 in ACI patients and intima media thickness(IMT)and NIHSS score were analyzed by Pearson methods.The Logistic regression analysis was conducted to explore the risk factors of carotid plaque formation in ACI patients.The clinical efficacy of serum CCL14 expression level in ACI patients in diagnosing carotid plaque formation and unstable plaque was analyzed by ROC curve.Results There were 87 significantly up-regulated genes and 60 significantly down-regulated genes in the plaque tissues compared with the paracacular tissue.The gene expression level of CCL14 in plaque and parapacal tissues were(0.78±0.12)and(0.34±0.10),respectively.Compared with paracacular tissues,the expression level of CCL14 gene in plaque tissues was significantly increased,and the difference was statistically significant(P<0.05).Compared with the control group,the serum expression level of CCL14 was significantly increased in ACI group[(34.55±3.45)pg/ml vs.(87.23±5.34)pg/ml,t=57.854,P<0.001].The serum expression level of CCL14 in non-plaque group,the stable and unstable plaque group were(76.12±4.98)pg/ml,(82.88±5.17)pg/ml,and(92.35±4.29)pg/ml,respectively.There were significant differences in the serum expression level of CCL14 among the three groups(F=34.111,P<0.001).The serum expression levels of CCL14 in stable and unstable plaque groups were significantly higher than that in non-plaque group(P<0.05),and the serum expression level of CCL14 in unstable plaque group was significantly higher than that in stable plaque group(P<0.001).Compared with the non-plaque group,the NIHSS score,C-reactive protein,D-dimer,infarct volume and CCL14 expression level were significantly increased in the plaque group,with a statistical significance(P<0.05).Correlation analysis results confirmed that the serum expression level of CCL14 in ACI patients was significantly positively correlated with IMT and NIHSS score,with correlation coefficients r=0.456,r=0.781,P<0.05.The expression levels of C-reactive protein(OR=1.671),D-dimer(OR=2.115)and CCL14(OR=2.871)were independent risk factors for carotid plaque formation in ACI patients.ROC curve results showed that the AUC of serum expression level of CCL14 in diagnosing carotid plaque formation in ACI patients was 0.781,the CCL14 cut-off value was 83.12 pg/ml,the diagnostic sensitivity and specificity were 83.12%and 86.87%,respectively.The AUC of serum expression level of CCL14 in diagnosing carotid artery unstable plaque formation in ACI patients was 0.856,the CCL14 cut-off value was 87.98 pg/ml,and the diagnostic sensitivity and specificity were 87.15%and 90.44%,respectively.Conclusions The serum expression level of CCL14 is significantly over-expressed in ACI patients,which could serve as a biomarker in evaluating the carotid plaque and unstable plaque formation in ACI patients.
作者
徐晓敏
邱茜茜
饶雷萍
董月
刘浩
曾萍
Xu Xiaomin;Qiu Qianqian;Rao Leiping;Dong Yue;Liu Hao;Zeng Ping(The Second Department of Neurology,Central Hospital of Jiaozuo Coal Group,Jiaozuo,Henan 454150,China;Department of Neurology,The First Affiliated Hospital of Xinxiang Medical University,Xinxiang,Henan 453100,China;Department of Neurology/Hospital Infection Management,The First Affiliated Hospital of Xinxiang Medical University,Xinxiang,Henan 453100,China)
出处
《齐齐哈尔医学院学报》
2025年第8期754-759,共6页
Journal of Qiqihar Medical University
基金
河南省医学科技攻关计划项目(LHGJ20220634)。
