老年代谢综合征患者颈动脉内膜中层厚度与血管内皮功能及血管粘附因子-1的相关性

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目的:探讨老年代谢综合征(MS)患者颈动脉内膜中层厚度(IMT)与血管内皮功能及血管粘附因子-1(VCAM-1)的相关性。方法:选取2013年1月~2014年10月我院收治的50例MS患者分为老年组(n=25)和中青年组(n=25),又根据IMT分为正常组和增厚组两个亚组。比较老年组和中青年组患者的临床资料,采用放射免疫分析法检测所有患者内皮素-1(ET-1)水平,采用分光光度计间接比色法检测一氧化氮(NO)水平,采用ELISA法检测VCAM-1水平,采用超声诊断仪检测IMT。结果:老年MS组和中青年MS组临床资料比较,差异均无统计学意义(均P>0.05);MS患者IMT增厚组的NO水平均低于IMT正常组,而ET-1和VCAM-1水平均高于IMT正常组,比较差异有统计学意义(均P<0.05)。IMT增厚组间比较,老年MS组的NO水平低于中青年MS组,VCAM-1水平高于中青年MS组,比较差异均有统计学意义(P<0.05);老年MS组和中青年MS组的IMT与NO水平呈负相关(r=-0.415,-0.411;P=0.043,0.049),与ET-1和VCAM-1水平呈正相关(r=0.585,0.576;P=0.030,0.036;r=0.547,0.552;P=0.033,0.031)。结论:血管内皮功能障碍和动脉粥样硬化等多重因素促进了MS患者IMT增厚中病理过程的发生和发展。 Objective: To investigate the relationship between carotid intima-media thickness (IMT) and vascular endothelial function and vascular adhesion molecule-1 (VCAM-1) in elderly patients with metabolic syndrome (MS). Methods: Fifty patients with MS who were admitted to our hospital from January 2013 to October 2014 were divided into the elderly group (n = 25) and the middle-aged and young group (n = 25), and then divided into normal group and thickening group according to IMT Two subgroups. The clinical data of elderly patients and middle-aged patients were compared. The levels of ET-1 in all patients were measured by radioimmunoassay. Nitric oxide (NO) level was measured by indirect colorimetric assay. Method to detect the level of VCAM-1, using ultrasonic diagnostic apparatus to detect IMT. Results: There was no significant difference in the clinical data between the elderly MS group and the middle-aged and young MS group (all P> 0.05). The NO level in MS patients with IMT thickening group was lower than that in normal IMT group, while ET-1 and VCAM- 1 levels were higher than the IMT normal group, the difference was statistically significant (P <0.05). Compared with young MS group, the level of NO in senile MS group was lower than that in middle-aged MS group, and the level of VCAM-1 was higher than that in middle-aged MS group (P <0.05) There was a negative correlation between IMT and NO levels in MS group (r = -0.415, -0.411; P = 0.043,0.049), and positively correlated with ET-1 and VCAM-1 levels r = 0.547, 0.552; P = 0.033, 0.031). Conclusion: Multiple factors such as vascular endothelial dysfunction and atherosclerosis promote the occurrence and development of pathological processes in IMT thickened MS patients.
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