关键词: 急性脑梗死, 　颈动脉粥样硬化, 　斑块稳定性, 　磷酸化神经丝蛋白H, 　过氧化物还原蛋白6

Abstract:

 Objective　To analyze the relationship of the serum levels of phosphorylated neurofilament protein H (pNF-H) and peroxidoreductin 6 (Prdx6) with the stability of carotid atherosclerotic plaques in patients with acute cerebral infarction (ACI) and its clinical significance. Methods　A total of 110 patients with ACI treated at Xianyang First People's Hospital from April 2022 to March 2024 were selected as a study group, including 54 males and 56 females. They were (63.04±7.76) years old. There were 39 mild cases, 48 moderate cases, and 23 severe cases. There were 36 cases without plaques, 44 cases with stable plaques, and 30 cases with unstable plaques. Fifty healthy subjects in the same period were selected as a control group. The patients' clinical data were collected. The serum levels of pNF-H and Prdx6 in each group were detected. The Spearman correlation analysis was used to analyze the relationship of serum levels of pNF-H and Prdx6 with the infarction degree and plaque stability. The risk factors of plaque instability were analyzed by the logistic regression. The receiver operating characteristic curve (ROC) was used to analyze the efficacies of both methods in the prediction of ACI plaque instability. Results　The serum levels of pNF-H and Prdx6 in the study group were (0.57±0.07) μg/L and (46.57±5.64) ng/L, and those in the control group (0.31±0.03) μg/L and (81.25±7.34) ng/L, with statistical differences (both P<0.05); with the aggravation of ACI infarction, the levels of PNF-H and PrDX6 gradually increased or decreased, with statistical differences (all P<0.05). Compared with those in the non-plaque group, the levels of hyperlipidemia, hypertension, low density lipoprotein cholesterol (LDL-C), apolipoprotein (ApoB), cystatin C (Cys-C), homocysteine (Hcy), and pNF-H in the plaque stable group and the plaque unstable group were higher, and the levels of Prdx6 were lower; those in the unstable group were higher or lower than those in the stable group; there were statistical differences (all P<0.05). Hyperlipidemia and the levels of ApoB, Hcy, Cys-C, pNF-H, and Prdx6 were independent factors affecting the stability of carotid atherosclerotic plaques in the patients (all P<0.05). The stability of carotid atherosclerotic plaques and the infarction degree in the patients were positively correlated with serum pNF-H level (r=0.556 and 0.571; both P<0.05), and negatively with serum Prdx6 level (r=-0.534 and -0.515; both P<0.05). When the cut-off values of serum pNF-H and Prdx6 were 0.63 μg/L and 43.77 ng/L, respectively, the area under the curve of the combination for predicting the instability of carotid atherosclerotic plaques was 0.910 (95%CI 0.853-0.968), with a sensitivity of 92.30% and a specificity of 81.20%; the diagnostic efficacy was better than that of single indicator. Conclusion　The increase of serum pNF-H level and the decrease of Prdx6 level are closely related to the degree of ACI and the stability of carotid atherosclerotic plaques, which have high predictive efficacy in evaluating the incidence of ACI and judging the stability of carotid atherosclerotic plaques.

Key words:  , Acute cerebral infarction,  , Carotid atherosclerosis,  , Plaque stability,  , pNF-H,  , Prdx6