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高血压合并动脉粥样硬化患者血清ADAM-10、suPAR水平与病情严重程度的关系
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(邯郸市眼科医院(邯郸市第三医院)内科,河北省邯郸市 056000)

作者简介:

刘俊红,主治医师,研究方向为内科诊断与治疗,E-mai:u61kpq@163.com。

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河北省科技厅科研评价项目(913-00-2021-008)


Relationship between serum levels of ADAM-10, suPAR and the severity in hypertension patients with atherosclerosis
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Department of Internal Medicine, Handan Eye Hospital & The Third Hospital of Handan, Handan, Hebei 056000, China)

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    目的]探讨高血压合并动脉粥样硬化患者血清中解整合素-金属蛋白酶10(ADAM-10)、可溶性尿激酶型纤溶酶原激活物受体(suPAR)的水平及其与病情严重程度的关系。 [方法]选取2021年2月—2023年2月期间于本院就诊的125例高血压合并动脉粥样硬化患者作为研究组,另选取同期体检健康者76例作为对照组。根据研究组患者动脉粥样硬化程度将其分为轻度组(n=40)、中度组(n=42)和重度组(n=43),治疗60天后,根据患者的预后情况将其分为预后良好组(n=74)与预后不良组(n=51)。采用ELISA法测定血清ADAM-10、suPAR水平;比较不同预后患者的临床资料;采用Pearson法分析高血压合并动脉粥样硬化患者血清ADAM-10、suPAR水平与颈动脉内膜中膜厚度(IMT)的关系;采用多因素Logistic回归分析高血压合并动脉粥样硬化患者预后不良的影响因素;采用受试者工作特征(ROC)曲线评估ADAM-10、suPAR单独及联合检测对高血压合并动脉粥样硬化预后不良的预测价值。 [结果]研究组血清ADAM-10、suPAR水平均明显高于对照组(P<0.05);中度、重度组患者血清ADAM-10、suPAR水平明显高于轻度组(P<0.05),重度组患者血清ADAM-10、suPAR水平明显高于中度组(P<0.05);预后不良组患者血清ADAM-10和suPAR水平、左右侧IMT、收缩压、舒张压明显高于预后良好组(P<0.05);Pearson相关性分析结果显示,高血压合并动脉粥样硬化患者血清ADAM-10和suPAR水平与收缩压、舒张压和IMT均呈正相关(P<0.001);Logistic回归分析结果显示,收缩压、舒张压和ADAM-10、suPAR水平升高及IMT增加是影响高血压合并动脉粥样硬化患者预后不良的危险因素(P<0.05);ROC曲线分析结果显示,血清ADAM-10、suPAR水平单独及联合预测高血压合并动脉粥样硬化预后不良的曲线下面积(AUC)分别为0.819、0.830、0.900,二者联合优于各自单独预测(Z二者联合-ADAM-10=2.766,P=0.006;Z二者联合-suPAR=2.602,P=0.009)。 [结论]高血压合并动脉粥样硬化患者血清ADAM-10、suPAR水平明显升高,且与动脉粥样硬化严重程度呈正相关,两者对评估高血压合并动脉粥样硬化患者预后有较高的预测价值。

    Abstract:

    Aim To investigate the levels of a disintegrin and metalloprotease 10 (ADAM-10) and soluble urokinase plasminogen activator receptor (suPAR) in the serum of hypertension patients with atherosclerosis and their relationship with the severity of disease. Methods From February 2021 to February 3,5 hypertension patients with atherosclerosis who visited our hospital were collected as the study group, and 76 healthy people were collected as control group. The patients in the study group were grouped into mild group (n=40), moderate group (n=42) and severe group (n=43) according to the degree of atherosclerosis, after 60 days of treatment, the patients were grouped into a good prognosis group (n=74) and a poor prognosis group (n=51) based on their prognosis. Enzyme linked immunosorbent assay (ELISA) was applied to measure serum ADAM-10 and suPAR levels; Clinical data of patients with different prognosis were compared; Pearson method was applied to analyze the relationship between serum ADAM-10, suPAR levels and carotid intima-media thickness (IMT) in patients with hypertension and atherosclerosis; Multivariate Logistic regression was applied to analyze the influencing factors of poor prognosis in patients with hypertension and atherosclerosis; Receiver operating characteristic (ROC) curve was applied to evaluate the predictive value of ADAM-10 and suPAR alone and jointly for poor prognosis of hypertension with atherosclerosis. Results The levels of serum ADAM-10 and suPAR were significantly higher in the study group than those in control group (P<0.05); The serum ADAM-10 and suPAR levels in moderate group and severe group were obviously higher than those in mild group (P<0.05), while the serum ADAM-10 and suPAR levels were obviously higher in severe group than those in moderate group (P<0.05); The serum ADAM-10 and suPAR levels, left and right IMT, systolic blood pressure, and diastolic blood pressure of patients with poor prognosis were significantly higher than those of patients with good prognosis (P<0.05); Pearson correlation analysis showed that serum ADAM-10 and suPAR levels in patients with hypertension and atherosclerosis were positively correlated with systolic blood pressure, diastolic blood pressure and IMT (P<0.001); Logistic regression analysis showed that the increased levels of systolic blood pressure, diastolic blood pressure, ADAM-10, suPAR and IMT were risk factors for poor prognosis of hypertension patients with atherosclerosis (P<0.05); ROC curve analysis showed that the area under the curve (AUC) of serum ADAM-10 and suPAR levels alone and jointly predicting poor prognosis of hypertension with atherosclerosis was 0.9,0.830 and 0.900, respectively, the combination of the two was superior to their individual predictions (Zcombination-ADAM-10=2.766, P=0.006; Zcombination-suPAR=2.602, P=0.009).Conclusion The levels of serum ADAM-10 and suPAR in patients with hypertension and atherosclerosis are significantly increased, and are positively correlated with the severity of atherosclerosis. Both of them have a high predictive value for evaluating the prognosis of patients with hypertension and atherosclerosis.

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刘俊红,申永慧,赵林妍,郭变香,王群超.高血压合并动脉粥样硬化患者血清ADAM-10、suPAR水平与病情严重程度的关系[J].中国动脉硬化杂志,2024,32(8):677~682.

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  • 收稿日期:2023-11-09
  • 最后修改日期:2023-12-26
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  • 在线发布日期: 2024-08-21
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