血管生成素样蛋白2在下肢动脉粥样硬化闭塞症血浆中的变化及其意义

摘要

Objective To investigated the changes of angiopoietin-like protein 2 (Angptl2) in patients with arteriosclerotic occlusion (ASO).Methods A total of 140 subjects including 75 ASO patients (ASO group) and 65 healthy subjects (control group) were enrolled in this study.Angptl2 and adiponectin were evaluated by using enzyme-linked immunosorbent assay.Biochemical data and high sensitive C reactive protein were measured and recorded as well.Results Compared to the control group,the ASO group presented with significantly higher level of plasma Angptl2 [(13.55 ± 9.17) μg/L vs.(9.04 ±4.79) μg/L,P =0.010].Plasma Angptl2 level of critical limb ischemia subjects was significantly higher than that of intermittent claudication subjects [(17.01 ± 10.20) μg/L vs.(10.53 ± 6.97) μg/L,P =0.003].The best diagnostic cutoff value of Angptl2 was 13.67 μg/L,with a sensitivity of 60.34％ and a specificity of 81.25 ％.In addition,type 2 diabetes mellitus patients with ASO exhibited significantly higher serum Angptl2 levels [(18.67 ±9.84) pμg/L] than those without ASO [(13.01 ± 3.47) μg/L] (P =0.021).In ASO group,serum Angptl2 levels were negatively correlated with ankle brachial index (r =-0.244,P =0.035).Conclusions The plasma level of Angptl2 increases in ASO patients.Its level is remarkably increased when the disease progressions to critical limb ischemia.Angptl2 can be a potential biological marker of disease progression.%目的 探讨血管生成素样蛋白2(Angptl2)在下肢动脉粥样硬化闭塞症患者血浆中的水平,以及其在下肢动脉粥样硬化闭塞症不同阶段的变化及其意义.方法 分析75例下肢动脉粥样硬化闭塞症患者(病例组)及65例健康体检者(对照组)血浆Angptl2水平.常规检测血生化指标及超敏C反应蛋白,采用酶联免疫分析法测定血浆Angptl2、脂联素水平.结果 下肢动脉粥样硬化闭塞症患者血浆Angptl2水平较健康对照显著升高[(13.55±9.17) μg/L比(9.04±4.79)μg/L,P=0.010].糖尿病人群中,下肢动脉粥样硬化闭塞症患者的血浆Angptl2水平(18.67 ±9.84) μg,/L较对照组(13.01±3.47)μg/L升高(P=0.021).在重症下肢缺血组Angptl2水平较间歇性跛行组更高[(17.01±10.20)tμg/L比(10.53±6.97)μg/L,P=0.003].Angptl2＞ 13.67 μg/L诊断效果最好,敏感性为60.34％,特异性为81.25％.在病例组中,血浆Angptl2水平与踝-肱指数呈负相关(斯皮尔曼相关系数=-0.244,P=0.035).结论 下肢动脉粥样硬化闭塞症患者的血浆Angptl2水平升高.当疾病进展为重症下肢缺血时,Angptl2水平的升高更为明显,可以作为判断疾病进展程度的潜在生物学标志物.