摘要
目的探讨血清血管内皮生长因子(vascular endothelial growth factor,VEGF)、VEGF受体2(VEGF receptor 2,VEGFR2)与老年急性缺血性卒中(acute ischemic stroke,AIS)患者颈动脉斑块稳定性的相关性。方法选取2022年4月至2024年4月在咸阳市第一人民医院经颈动脉超声检查存在颈动脉斑块的老年AIS患者,并进一步分为稳定斑块组和易损斑块组。通过多变量logisitic回归分析确定血清VEGF和VEGFR2与颈动脉斑块稳定性的相关性,采用受试者工作特征(receiver operating characteristic,ROC)曲线分析血清VEGF和VEGFR2对斑块稳定性的鉴别价值。结果共纳入183例患者,男性139例(75.96%),年龄(68.10±4.97)岁。101例(55.19%)存在易损斑块,82例(44.81%)存在稳定斑块。易损斑块组年龄、甘油三酯、VEGF、VEGFR2、基线美国国立卫生研究院卒中量表评分以及存在高血压、糖尿病、吸烟和服用他汀类药物的患者比例与稳定斑块组差异有统计学意义(P均<0.05)。多变量logistic回归分析显示,血清VEGF[优势比(odds ratio,OR)1.021,95%置信区间(confidence interval,CI)1.004~1.037;P=0.015]和VEGFR2(OR 1.009,95%CI 1.005~1.012;P<0.001)与易损斑块独立相关。ROC曲线分析显示,血清VEGF和VEGFR2单独鉴别斑块稳定性的效能良好,曲线下面积分别为0.744(95%CI 0.673~0.815)和0.809(95%CI 0.749~0.870),两者联合的曲线下面积为0.874(95%CI 0.825~0.924)。结论血清VEGF和VEGFR2与老年AIS患者颈动脉易损斑块独立相关,两者单独或联合对颈动脉斑块稳定性具有良好的鉴别价值。
Objective To investigate associations of serum vascular endothelial growth factor(VEGF)and vascular endothelial growth factor receptor 2(VEGFR2)with carotid plaque stability in elderly patients with acute ischemic stroke(AIS).Methods Elderly AIS patients with carotid plaque detected by carotid ultrasound in the First People's Hospital of Xianyang from April 2022 to April 2024 were selected,and they were further divided into stable plaque group and vulnerable plaque group.Multivariate logisitic regression analysis was used to determine the correlation between serum VEGF/VEGFR2 and carotid plaque stability.Receiver operating characteristic(ROC)curve was used to analyze the differential value of serum VEGF and VEGFR2 on plaque stability.Results A total of 183 patients were enrolled,including 139 males(75.96%),aged 68.10±4.97 years.One hundred and one patients(55.19%)had vulnerable plaques,and 82(44.81%)had stable plaques.There were significant differences in age,triglycerides,VEGF,VEGFR2,baseline National Institutes of Health Stroke Scale scores,and the proportion of patients with hypertension,diabetes,smoking,and statins between the vulnerable plaque group and the stable plaque group(all P<0.05).Multivariate logistic regression analysis showed that serum VEGF(odds ratio[OR]1.021,95% confidence interval[CI]1.004-1.037;P=0.015)and VEGFR2(OR 1.009,95%CI 1.005-1.012;P<0.001)were independently associated with vulnerable plaques.ROC curve analysis showed that serum VEGF and VEGFR2 alone were effective in distinguishing plaque stability,and the areas under the curve were 0.744(95%CI 0.673-0.815)and 0.809(95%CI 0.749-0.870),respectively.The area under the curve of the combination of the two was 0.874(95%CI 0.825-0.924).Conclusion Serum VEGF and VEGFR2 are independently associated with vulnerable carotid plaques in elderly patients with AIS,and both alone or in combination have good discriminatory value for the stability of carotid plaques.
作者
康永刚
车璐
王雨刚
程少强
姚力
Kang Yonggang;Che Lu;Wang Yugang;Cheng Shaoqiang;Yao Li(Department of Neurology,the First People's Hospital of Xianyang,Xianyang 712000,China;Department of Neurology,XD Group Hospital,Xi'an 710100,China)
出处
《国际脑血管病杂志》
2024年第12期922-927,共6页
International Journal of Cerebrovascular Diseases
基金
陕西省自然科学基础研究计划项目(S2024-JC-YB-0161)。
关键词
缺血性卒中
颈动脉
斑块
动脉粥样硬化
血管内皮生长因子A
受体
血管内皮生长因子
试验预期值
超声检查
生物标志物
Ischemic stroke
Carotid arteries
Plaque,atherosclerotic
Vascular endothelial growth factor A
Receptors,vascular endothelial growth factor
Predictive value of tests
Ultrasonography
Biomarkers
