PCSK9水平与颈动脉内膜中层厚度的关系分析

刘欣; 牛慧敏; 于明月; 张明明; 高丽

doi:10.13201/j.issn.1001-1439.2020.06.011

PCSK9水平与颈动脉内膜中层厚度的关系分析

- 1. 河北省人民医院超声科(石家庄, 050051);
- 2. 河北省人民医院检验科
基金项目:
河北省卫健委重点研究课题（No：20190307）

详细信息

通讯作者: 高丽,E-mail:nhm7865@163.com

中图分类号: R543

收稿日期: 2019-06-05

修回日期: 2019-12-26

Analysis of relationship between PCSK9 level and carotid IMT

- 1. Department of Ultrasound, Hebei General Hospital, Shijiazhuang, 050051, China;
- 2. Clinical Laboratory, Hebei General Hospital

More Information

Corresponding author: GAO Li, E-mail: nhm7865@163.com

Received Date: 05 June 2019

Revised Date: 26 December 2019

摘要

摘要: 目的：探讨血清中前蛋白转化酶枯草杆菌蛋白酶9（PCSK9）水平与颈动脉内膜中层厚度（IMT）的关系及其在动脉粥样硬化事件进展中的影响。方法：选取327例无症状受试者，依据PCSK9水平分为正常组（210例）和动脉粥样硬化组（117例），颈动脉IMT通过高分辨率B型颈动脉超声检测，血清中PCSK9水平通过免疫测定法测量。结果：在单因素分析中，总体受试者及动脉粥样硬化组的IMT与PCSK （总体：r=0.203，P=0.001；动脉粥样硬化组：r=0.415，P<0.001）、年龄（总体：r=0.160，P=0.012；动脉粥样硬化组：r=0.299，P=0.018）具有相关性。在多因素回归分析中，包括性别、高血压、吸烟状况、肥胖、是否服用胆固醇药物和血清PCSK9，血清PCSK9浓度仍然是平均颈动脉IMT的显著且独立预测因子（P<0.001）。结论：亚临床颈动脉粥样硬化的风险增加可能由血清中PCSK9的水平状态增高所导致，与常规危险因素无关。但抑制血清中PCSK9水平是否可以改善心血管事件结果，仍需在大型临床试验中证实。
- 前蛋白转化酶枯草杆菌蛋白酶9 /
- 颈动脉内膜中层厚度 /
- 心血管事件
Abstract: Objective: To investigate the relationship between the level of Proprotein convertase subtilisin kexin type 9 (PCSK9) and carotid intima-medial wall thickness (IMT) and the role of PCSK9 in the development of atherosclerosis.Method: A total of 327 asymptomatic subjects were selected and divided into the normal group (210 cases) and atherosclerosis group (117 cases) based on the PCSK9 level.Carotid IMT was detected by high-resolution B-type carotid ultrasound, and serum PCSK9 was measured by immunoassay.Result: In univariate analysis, the correlation of IMT with PCSK9 (overall:r=0.203, P=0.001;the atherosclerosis group:r=0.415, P<0.001) and age (overall:r=0.160, P=0.012;atherosclerosis group:r=0.299, P=0.018) was statistically significant in the overall subject and the atherosclerosis group.In multivariate regression analysis, including gender, hypertension, smoking status, obesity, whether to take cholesterol-lowing drugs and serum PCSK9, serum PCSK9 concentration was still a significant and independent predictor of mean carotid IMT (P<0.001).Conclusion: The increased risk of subclinical carotid atherosclerosis may be caused by serum levels of PCSK9, independent of conventional risk factors.However, whether PCSK9 inhibition can improve cardiovascular outcomes remains to be confirmed in large clinical trials.
- PCSK9 /
- carotid intima-medial wall thickness /
- cardiovascular disease

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参考文献(13)

[1]	廖玉华, 程翔.非HDL-C与动脉粥样硬化性心血管病[J].临床心血管病杂志, 2014, 30(9):743-745.
[2]	Gisterå A, Ketelhuth DFJ.Lipid-driven immunometabolic responses in atherosclerosis[J].Curr Opin Lipidol, 2018, 29(5):375-380.
[3]	梁春.强化降脂和抗炎"双达标"防治动脉粥样硬化性心血管疾病:虚拟还是现实?[J].临床心血管病杂志, 2019, 35(9):775-776.
[4]	Bäck M, Yurdagul A Jr, Tabas I, et al.Inflammation and its resolution in atherosclerosis:mediators and therapeutic opportunities[J].Nat Rev Cardiol, 2019, 16(7):389-406.
[5]	Laitinen TT, Pahkala K, Magnussen C G, et al.Lifetime measures of ideal cardiovascular health and their association with subclinical atherosclerosis:the Cardiovascular Risk in Young Finns Study[J].Int J Cardiol, 2015, 185:186-191.
[6]	Tang ZH, Peng J, Ren Z, et al.New role of PCSK9 in atherosclerotic inflammation promotion involving the TLR4/NF-κB pathway[J].Atherosclerosis, 2017, 262:113-122.
[7]	Cainzos-Achirica M, Martin SS, Cornell JE, et al.PCSK9 inhibitors:a new era in lipid-lowering treatment?[J].Ann Intern Med, 2015, 163(1):64-65.
[8]	Amato M, Veglia F, de Faire U, et al.Carotid plaque-thickness and common carotid IMT show additive value in cardiovascular risk prediction and reclassification[J].Atherosclerosis, 2017, 263:412-419.
[9]	Ference B A, Robinson JG, Brook RD, et al.Variation in PCSK9 and HMGCR and risk of cardiovascular disease and diabetes[J].N Eng J Med, 2016, 375(22):2144-2153.
[10]	Ferri N, Ruscica M.Proprotein convertase subtilisin/kexin type 9(PCSK9) and metabolic syndrome:insights on insulin resistance, inflammation, and atherogenic dyslipidemia[J].Endocrine, 2016, 54(3):588-601.
[11]	Chan DC, Wong AT, Pang J, et al.Inter-relationships between proprotein convertase subtilisin/kexin type?9, apolipoprotein C-III and plasma apolipoprotein B-48 transport in obese subjects:a stable isotope study in the postprandial state[J].Clin Sci(Lond), 2015, 128(6):379-385.
[12]	Huijgen R, Fouchier SW, Denoun M, et al.Plasma levels of PCSK9 and phenotypic variability in familial hypercholesterolemia[J].J Lipid Res, 2012, 53(5):979-983.
[13]	廖玉华, 魏晶晶.他汀和PCSK9抑制剂调节LDL-C合成与清除代谢的临床荟萃分析[J].临床心血管病杂志, 2016, 32(6):537-540.