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颈动脉内中膜厚度联合血清半乳凝集素-3和正五聚蛋白3对银屑病患者并发心血管疾病的诊断价值

Diagnostic value of combining carotid intima-media thickness with serum galectin-3 and pentraxin 3 in patients with psoriasis complicated with cardiovascular disease

    摘要
  • 摘要:
    目的 探讨颈动脉内中膜厚度(cIMT)联合血清半乳凝集素-3(Gal-3)和正五聚蛋白3(PTX3)对银屑病患者并发心血管疾病(CVD)的诊断价值。
    方法 将38例银屑病伴CVD患者纳入CVD组, 将51例单纯银屑病患者纳入银屑病组，另选取同期60例健康体检者纳入对照组。收集各组临床资料，使用颈动脉彩超检测cIMT, 采用酶联免疫吸附试验检测血清Gal-3、PTX3和炎性指标超敏C反应蛋白(hs-CRP)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)水平。采用多因素Logistic回归分析明确银屑病患者并发CVD的影响因素，绘制受试者工作特征(ROC)曲线，评估血清Gal-3、PTX3和cIMT对CVD的诊断价值。
    结果 CVD组、银屑病组cIMT大于对照组，且CVD组大于银屑病组，差异有统计学意义(P < 0.05); CVD组和银屑病组血清Gal-3、PTX3、hs-CRP、PCT、TNF-α水平高于对照组，且CVD组高于银屑病组，差异有统计学意义(P < 0.05); CVD组银屑病皮损面积和严重程度指数(PASI)评分高于银屑病组，差异有统计学意义(P < 0.05)。Pearson积矩相关分析结果显示, cIMT、Gal-3、PTX3均分别与hs-CRP、PCT、TNF-α呈正相关(P < 0.05)。多因素Logistic回归分析结果显示, PASI评分、cIMT、Gal-3、PTX3、hs-CRP、TNF-α均为银屑病患者并发CVD的独立影响因素(OR=1.250、1.451、1.432、1.365、1.413、1.465, P < 0.05)。基于cIMT和血清Gal-3、PTX3联合构建的诊断模型对银屑病患者并发CVD的诊断价值高于单独诊断，曲线下面积为0.922, 灵敏度、特异度分别为0.91、0.85。
    结论 cIMT、血清Gal-3、血清PTX3是银屑病患者并发CVD的独立影响因素，三者联用对银屑病患者并发CVD具有较高的诊断价值。

     

    Abstract:
    Objective To investigate the diagnostic value of combining carotid intima-media thickness (cIMT) with serum Galectin-3 (Gal-3) and Pentraxin 3 (PTX3) in patients with psoriasis complicated with cardiovascular disease (CVD).
    Methods Thirty-eight patients with psoriasis complicated with CVD were included in CVD group, 51 patients with psoriasis alone were included in psoriasis group, and 60 healthy subjects were selected as control group. Clinical data were collected from each group. The cIMT was measured using carotid ultrasound, and serum Gal-3, PTX3, and inflammatory markershigh sensitivity C-reactive protein (hs-CRP), procalcitonin (PCT), tumor necrosis factor-α (TNF-α)were detected using enzyme-linked immunosorbent assay. Multivariate Logistic regression analysis was used to identify the influencing factors of CVD in patients with psoriasis. The receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic value of serum Gal-3, PTX3, and cIMT for CVD.
    Results The cIMT was greater in the CVD group and the psoriasis group than in the control group, and the CVD group was greater than the psoriasis group (P < 0.05). The serum levels of Gal-3, PTX3, hs-CRP, PCT, and TNF-α were higher in the CVD group and the psoriasis group than in the control group, and their levels were higher in the CVD group than in the psoriasis group (P < 0.05). The psoriasis area and severity index (PASI) score was higher in the CVD group than in the psoriasis group (P < 0.05). Pearson's correlation analysis showed that cIMT, Gal-3, and PTX3 were separately positively correlated with hs-CRP, PCT, and TNF-α (P < 0.05). Multivariate Logistic regression analysis showed that PASI score, cIMT, Gal-3, PTX3, hs-CRP, and TNF-α were independent influencing factors for CVD in patients with psoriasis (OR=1.250, 1.451, 1.432, 1.365, 1.413, 1.465; P < 0.05). The diagnostic model based on cIMT combined with serum Gal-3 and PTX3 had higher diagnostic value for CVD in patients with psoriasis than single diagnosis. The area under the curve was 0.922, with sensitivity and specificity of 0.91 and 0.85, respectively.
    Conclusion The cIMT, serum Gal-3, and serum PTX3 are independent influencing factors for CVD in patients with psoriasis. The combination of the three indicators has higher diagnostic value for CVD in patients with psoriasis.

     

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