脂联素及内皮型一氧化氮合成酶与颈动脉斑块的关系

目的：探讨脂联素（APN）及内皮型一氧化氮合成酶（eNOS）水平与颈动脉斑块的关系。方法：300例接受颈动脉超声检查的住院患者,根据颈动脉粥样硬化斑块指数分为正常对照组（0级,70例）、斑块1级组（80例）、斑块2级组（80例）、斑块3级组（70例）,根据斑块性质又分为软斑组（88例）和硬斑组（142例）,观察各组APN水平及eNOS和内皮素-1（ET-1）的变化。结果：（1）与正常对照组比较,斑块2、3级组患者APN水平明显降低[（90.91±9.66）μg/ml比（52.87±11.12）μg/ml、（50.67±10.31）μg/ml],斑块1、2、3级组患者eNOS水平明显下降[（12.35±1.08）U/ml比（9.27±1.24）U/ml、（6.68±1.03）U/ml、（4.92±1.12）U/ml],ET-1水平明显升高[（100.25±4.46）ng/L比（152.46±5.12）ng/L、（164.87±4.58）ng/L、（206.47±5.09）ng/L],P〈0.05～〈0.01;Spearman线性相关分析表明APN水平与颈动脉软斑呈明显负相关（r=-0.83,P〈0.05）;（2）ROC曲线表明APN、eNOS指标对颈动脉有无斑块形成有预测价值（曲线下面积为0.674,0.681,P均〈0.01）。结论：颈动脉粥样硬化斑块患者血脂联素、eNOS水平显著下降,对颈动脉斑块形成有预测价值。

Correlation among adiponectin,endotheliocyte nitric oxide synthetase and carotid artery plaque

Objective: To investigate correlation among adiponectin(APN),endotheliocyte nitric oxide synthetase(eNOS)and carotid artery plaque.Methods:According to carotid atherosclerotic plaque index,a total of 300 inpatients undergoing carotid ultrasonography were divided into normal control group(n=70),plaque stage 1 group(n=80),plaque stage 2 group(n=80) and plaque stage 3 group(n=70).According to characteristics of carotid artery plaques,the patients were divided into soft plaque group(n=88) and hard plaque group(n=142).Changes of levels of APN,eNOS and endothelin(ET)-1 were observed in all groups.Results:(1) Compared with normal control group,there was significant decrease in APN level [(90.91±9.66) g/ml vs.(52.87±11.12) g/ml,(50.67±10.31) g/ml]in plaque stage 2 and 3 groups,significant decrease in eNOS level [(12.35±1.08) U/ml vs.(9.27±1.24) U/ml,(6.68±1.03) U/ml,(4.92±1.12) U/ml]and significant increase in ET-1 level [(100.25±4.46) ng/L vs.(152.46±5.12) ng/L,(164.87±4.58) ng/L,(206.47±5.09) ng/L]in plaque stage 1,2 and 3 groups,P<0.05~<0.01;Spearman linear correlation analysis showed that APN level was significant negatively correlated with soft plaque(r=-0.83,P<0.05);(2) ROC curve indicated that APN and eNOS may predict formation of carotid artery plaque [area under curve(AUC) = 0.674,0.681 respectively,P<0.01 all].Conclusion: Levels of adiponectin and eNOS decrease in patients with carotid artery plaque,may predict formation of carotid artery plaque.