血清Sema7A、CD163预测颈动脉粥样硬化斑块易损性的价值研究

Predictive values of serum Sema7A and CD163 in the vulnerability of carotid atherosclerotic plaque

摘要:

目的 分析血清Sema7A、CD163预测颈动脉粥样硬化斑块易损性的价值。方法 选取2019年4月—2022年4月徐州医科大学附属连云港医院收治的108例脑梗死患者，采用酶联免疫吸附试验检测患者血清Sema7A、CD163水平。根据彩色多普勒超声诊断仪检测患者颈动脉斑粥样硬化块性质分为稳定斑块组、不稳定斑块组，分析影响患者颈动脉粥样硬化斑块易损性的影响因素。绘制受试者工作特征（ROC）曲线，分析血清Sema7A、CD163预测颈动脉粥样硬化斑块易损性的价值。结果 不稳定斑块组LDL-C、脂蛋白a、中性粒细胞计数、Hcy、Sema7A、CD163水平高于稳定斑块组（P <0.05），不稳定斑块组淋巴细胞计数、颈动脉狭窄率低于稳定斑块组（P <0.05）。多因素Logistic逐步回归分析结果显示：LDL-C ［O^R=6.341（95% CI：2.609，15.410）］、脂蛋白a ［O^R=5.078（95% CI：2.090，12.342）］、Sema7A ［O^R=4.495（95% CI：1.850，10.925）］、CD163 ［O^R=3.927（95% CI：1.616，9.545）］是影响脑梗死患者颈动脉粥样硬化斑块易损性的因素（P <0.05）。ROC曲线分析结果显示，血清Sema7A、CD163及两者联合预测颈动脉粥样硬化斑块易损性的敏感性分别为71.43%、76.79%和80.36%，特异性分别为75.00%、73.08%和90.38%，AUC分别为0.754、0.743和0.927。结论 血清Sema7A、CD163的表达与脑梗死患者颈动脉粥样硬化斑块易损性有关，两者联合预测颈动脉粥样硬化斑块易损性效能良好。

Abstract:

Objective To analyze the predictive values of serum Semaphorin 7A (Sema7A) and hemoglobin scavenger receptor (CD163) in the vulnerability of carotid atherosclerotic plaque.Methods The 108 patients with cerebral infarction admitted to Lianyungang Hospital Affiliated to Xuzhou Medical University from April 2019 to April 2022 were selected. The serum levels of Sema7A and CD163 were detected by enzyme-linked immunosorbent assay. The patients were divided into stable plaque group and unstable plaque group according to the properties of carotid atherosclerotic plaques as detected by the color Doppler ultrasound. The factors affecting the vulnerability of carotid atherosclerotic plaques were analyzed, and the predictive values of serum Sema7A and CD163 in the vulnerability of carotid atherosclerotic plaques was determined.Results The levels of low-density lipoprotein cholesterol (LDL-C), lipoprotein a, neutrophil count, Hcy, Sema7A and CD163 were higher in the unstable plaque group than those in the stable plaque group (P < 0.05), while the lymphocyte count and incidence of carotid artery stenosis were lower in the unstable plaque group than those in the stable plaque group (P < 0.05). Multivariable Logistic regression analysis showed that LDL-C [O^R = 6.341 (95% CI: 2.609, 15.410) ], lipoprotein a [O^R = 5.078 (95% CI: 2.090, 12.342) ], Sema7A [O^R = 4.495 (95% CI: 1.850, 10.925) ] and CD163 [O^R = 3.927 (95% CI: 1.616, 9.545) ] were factors affecting the vulnerability of carotid atherosclerotic plaque in patients with cerebral infarction (P < 0.05). The receiver operating characteristic (ROC) curve analysis revealed that the sensitivities of serum Sema7A, CD163 and their combination for predicting the vulnerability of carotid atherosclerotic plaque were 71.43%, 76.79% and 80.36%, with the specificities being 75.00%, 73.08%, and 90.38%, and the areas under the ROC curves (AUCs) being 0.754, 0.743 and 0.927, respectively.Conclusions The expressions of Sema7A and CD163 in the serum are related to the vulnerability of carotid atherosclerotic plaque in patients with cerebral infarction, and the combination of SEMA7A and CD163 shows great efficacy in predicting the vulnerability of carotid atherosclerotic plaque.