内皮细胞特异性分子-1、细胞间黏附分子-1和血管细胞黏附分子-1水平预测老年高血压患者颈动脉粥样硬化的临床价值

Clinical value of endothelial cell-specific molecule-1,intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 in predicting carotid atherosclerosis in elderly hypertensive patients

中文关键词: 老年  高血压  颈动脉粥样硬化  内皮细胞特异性分子-1  细胞间黏附分子-1  血管细胞黏附分子-1

英文关键词: elderly  hypertension  carotid atherosclerosis  endothelial cell-specific molecule-1  intercellular adhesion molecule-1  vascular cell adhesion molecule-1

中文摘要:

      目的 探究老年高血压患者内皮细胞特异性分子-1(ESM-1)、细胞间黏附分子-1(ICAM-1)和血管细胞黏附分子-1(VCAM-1)对颈动脉粥样硬化(CAS)的预测价值.方法 选取2023年1月—2024年10月沧州市人民医院182例老年高血压患者.根据颈动脉内-中膜厚度(IMT)分为非CAS组(n=104)和CAS组(n=78).比较2组的年龄、性别、高血压病程、体质量指数、吸烟、饮酒、收缩压、舒张压、三酰甘油、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、ESM-1、ICAM-1和VCAM-1水平.二元Logistic回归法分析老年高血压患者CAS的危险因素;采用受试者操作特征(ROC)曲线评价血清ESM-1、ICAM-1和VCAM-1对老年高血压患者CAS的预测价值.结果 老年高血压患者CAS检出率为42.86％(78/182).与非CAS组相比,CAS组高血压病程较长,总胆固醇水平较高,颈动脉IMT较厚,血清ESM-1、ICAM-1和VCAM-1水平较高,差异有统计学意义(P＜0.05).二元Logistic回归分析显示,高血压病程长,总胆固醇水平高,颈动脉IMT厚,血清ESM-1、ICAM-1和VCAM-1水平高是老年高血压患者CAS的危险因素(P＜0.05).以162.61 ng/L为临界值,ESM-1预测CAS的曲线下面积(AUC)为0.799;以293.66 ng/L为临界值,ICAM-1预测CAS的AUC为0.778;以384.00 μg/L为临界值,VCAM-1预测CAS的AUC为0.758.3者联合预测CAS的AUC为0.901,优于各指标单独预测(P＜0.05).结论 老年高血压患者ESM-1、ICAM-1、VCAM-1表达可能与CAS有关,3者联合检测有望作为预测CAS的标志物.

英文摘要:

      Objective To explore the value of endothelial cell-specific molecule-1(ESM-1),intercellular adhesion molecule-1(ICAM-1)and vascular cell adhesion molecule-1(VCAM-1)in predicting carotid atherosclerosis(CAS)in elderly hypertensive patients.Methods 182 elderly hypertensive patients from People's Hospital of Cangzhou City between January 2023 and October 2024 were enrolled.Based on carotid intima-media thickness(IMT),they were divided into non-CAS group(n=104)and CAS group(n=78).The age,gender,course of hypertension,body mass index(BMI),smoking status,alco-hol consumption,systolic blood pressure(SBP),diastolic blood pressure(DBP),and serum levels of triglycerides(TG),to-tal cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),ESM-1,ICAM-1 and VCAM-1 were compared between the two groups.Binary Logistic regression was used to analyze risk factors for CAS.Receiver operating characteristic(ROC)curve analysis was employed to evaluate the predictive value of serum ESM-1,ICAM-1,and VCAM-1 for CAS.Results The detection rate of CAS in these patients was 42.86％(78/182).Compared with the non-CAS group,the CAS group had a significantly longer course of hypertension,higher TC levels,thicker carotid IMT,and higher serum levels of ESM-1,ICAM-1,and VCAM-1(all P＜0.05).Binary Logistic regression analysis showed that long course of hypertension,high TC level,thick carotid IMT,and high serum levels of ESM-1,ICAM-1,and VCAM-1 were independent risk factors for CAS in elderly hypertensive patients(P＜0.05).Taking 162.61 ng/L as the cut-off value,the area under the curve(AUC)of ESM-1 for predicting CAS was 0.799.Taking 293.66 ng/L as the cut-off value,the AUC of ICAM-1 for predicting CAS was 0.778.Taking 384.00 μg/L as the cut-off value,the AUC of VCAM-1 for predicting CAS was 0.758.The AUC of the combined prediction of CAS by the three indexes was 0.901,which was superior to the individual prediction of each index(P＜0.05).Conclusion The expression level of ESM-1,ICAM-1,and VCAM-1 in elderly hyper-tensive patients may be related to CAS,and their combined detection is expected to serve as a biomarker for predicting CAS.