脑梗死急性期血清中二肽基肽酶-3和胱天蛋白酶-9表达水平与患者颈动脉粥样硬化的相关性

Correlation of the expression levels of dipeptidyl peptidase-3 and caspase-9 in serum during the acute stage of cerebral infarction with carotid atherosclerosis in patients

摘要:

目的 探讨脑梗死急性期血清中二肽基肽酶-3（DPP3）和胱天蛋白酶-9（caspase-9）表达水平与患者颈动脉粥样硬化的相关性。方法 该研究为前瞻性研究。研究对象为2023年1月至2024年11月在邢台市中心医院进行治疗的脑梗死急性期患者212例（研究组），另选取同期进行健康体检的志愿者212例作为对照组。比较研究组与对照组、不同脑梗死组、不同颈动脉硬化组的DPP3和caspase-9表达水平之间的差异。采用线性相关分析和斯皮尔曼等级相关分析对DPP3和caspase-9与炎症指标、颈动脉硬化严重程度、梗死严重程度之间的相关性进行分析。采用多因素Logistic回归分析探讨造成患者重度脑梗死以及不稳定性斑块的危险因素，并检测DPP3和caspase-9的诊断效能。结果 研究组与对照组、不同脑梗死组、不同颈动脉硬化组间DPP3、caspase-9、肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）以及白细胞介素-6（IL-6）的比较，差异有统计学意义（均P<0.05）。相关性分析结果显示，DPP3和caspase-9与TNF-α、CRP、IL-6、颈动脉严重程度、脑梗死严重程度均呈正相关。多因素Logistic回归分析结果显示，DPP3、caspase-9、TNF-α、CRP以及IL-6均是造成患者重度脑梗死的危险因素。DPP3和caspase-9联合检测对于重度脑梗死以及不稳定性斑块的灵敏度高于单独诊断。结论 脑梗死急性期血清中DPP3和caspase-9表达水平与患者颈动脉粥样硬化有相关性，可以作为临床诊断的重要指标。

Abstract:

Objective To investigate the correlation of the expression levels of dipeptidyl peptidase-3 （DPP3） and caspase-9 in serum during the acute stage of cerebral infarction with the severity of carotid atherosclerosis in patients.Methods In this prospective study， 212 patients in the acute stage of cerebral infarction who were treated in Xingtai Central Hospital from January 2023 to November 2024 were enrolled as study group， and 212 volunteers who underwent physical examination during the same period of time were enrolled as control group. The expression levels of DPP3 and caspase-9 were compared between the study group and the control group， between the groups with different severities of cerebral infarction， and between the groups with different severities of carotid atherosclerosis. The linear correlation analysis and the Spearman rank correlation analysis were used to investigate the correlation of DPP3 and caspase-9 with inflammatory markers， the severity of carotid atherosclerosis， and the severity of infarction. The risk factors for severe cerebral infarction and unstable carotid plaque were identified by the multivariate Logistic regression analysis， and the diagnostic performance of DPP3 and caspase-9 was assessed.Results There were significant differences in DPP3， caspase-9， tumor necrosis factor-α （TNF-α）， C-reactive protein （CRP）， and interleukin-6 （IL-6） between the study group and the control group， between the groups with different severities of cerebral infarction， and between the groups with different severities of carotid atherosclerosis （P<0.05）. The correlation analysis showed that DPP3 and caspase-9 were positively correlated with TNF-α， CRP， IL-6， and the severity of carotid atherosclerosis and cerebral infarction. The multivariate Logistic regression analysis showed that DPP3， caspase-9， TNF-α， CRP， and IL-6 were risk factors for severe cerebral infarction. Combined measurement of DPP3 and caspase-9 showed a higher sensitivity than DPP3 or caspase-9 used alone in identifying severe cerebral infarction and unstable carotid plaque.Conclusions The expression levels of DPP3 and caspase-9 in serum during the acute stage of cerebral infarction are significantly correlated with carotid atherosclerosis in patients and can thus be used as important indexes for clinical diagnosis.