XU Yijun, TAO Chunhua, WANG Xingyi, ZHANG Song, LIU Zhensheng, WANG Yingge. Correlations of plasma proprotein convertase subtilisin/kexin type 9 level with different types of acute cerebral infarction and nature of carotid atherosclerotic plaque[J]. Journal of Clinical Medicine in Practice, 2022, 26(11): 53-57. DOI: 10.7619/jcmp.20220069
Citation: XU Yijun, TAO Chunhua, WANG Xingyi, ZHANG Song, LIU Zhensheng, WANG Yingge. Correlations of plasma proprotein convertase subtilisin/kexin type 9 level with different types of acute cerebral infarction and nature of carotid atherosclerotic plaque[J]. Journal of Clinical Medicine in Practice, 2022, 26(11): 53-57. DOI: 10.7619/jcmp.20220069

Correlations of plasma proprotein convertase subtilisin/kexin type 9 level with different types of acute cerebral infarction and nature of carotid atherosclerotic plaque

More Information
  • Received Date: January 05, 2022
  • Available Online: May 15, 2022
  • Objective 

    To investigate the correlations of plasma proprotein convertase subtilisin/kexin type 9(PCSK9) level with different types of acute cerebral infarction (ACI) and nature of carotid atherosclerotic plaque.

    Methods 

    Patients were divided into different groups according to TOAST classification, severity of the disease and stability of plaque, and PCSK9 level in each group was compared.Logistic regression analysis was used to explore the risk factors of unstable plaque, and the receiver operating characteristic (ROC) curve was drawn to evaluate the predictive effect of PCSK9.

    Results 

    Among the 236 enrolled subjects, 158 patients were diagnosed as ACI, and 142 of them were diagnosed with plaque.The plasma PCSK9 level in ACI patients was significantly higher than that in controls (P < 0.05);the PCSK9 level and the National Institutes of Health Stroke Scale (NIHSS) score in ACI patients with type of large atherosclerosis (LAA) were significantly higher than those in patients with other subtypes (P < 0.05);the PCSK9 level in the unstable plaque group was significantly higher than that in the stable plaque group (P < 0.05).PCSK9 was positively correlated with the degree of neurological impairment (rs=0.468, P < 0.05).Logistic regression analysis showed that PCSK9 was the risk factor for LAA-type ACI and carotid unstable plaque (OR=1.010, 95%CI, 1.001 to 1.019, P < 0.05;OR=1.007, 95%CI, 1.001 to 1.013, P < 0.05).ROC curve indicated that when the level of PCSK9 was higher than 438.21 ng/mL, the patients had higher risk of LAA-type ACI.

    Conclusion 

    PCSK9 may induce LAA-type cerebral infarction by inducing formation of carotid unstable plaque.

  • [1]
    王陇德, 刘建民, 杨弋, 等. 我国脑卒中防治仍面临巨大挑战: 《中国脑卒中防治报告2018》概要[J]. 中国循环杂志, 2019, 34(2): 105-119. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGXH201902002.htm
    [2]
    LIU L S, BAI X Q, GAO Y, et al. PCSK9promotes oxLDL-induced PC12 cell apoptosis through the bcl-2/bax-caspase 9/3 signaling pathway[J]. J Alzheimer's Dis, 2017, 57(3): 723-734. doi: 10.3233/JAD-161136
    [3]
    QI Z Y, HU L, ZHANG J J, et al. PCSK9 (proprotein convertase subtilisin/kexin 9) enhances platelet activation, thrombosis, and myocardial infarct expansion by binding to platelet CD36[J]. Circulation, 2021, 143(1): 45-61. doi: 10.1161/CIRCULATIONAHA.120.046290
    [4]
    中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2014[J]. 中华神经科杂志, 2015, 48(4): 246-257. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZL201606005.htm
    [5]
    王英歌, 陈露, 张新江, 等. 老年脑梗死患者血浆MMP-9、CD105和TIMP-1的表达水平及其与颈动脉粥样硬化斑块稳定性的相关性[J]. 中国老年学杂志, 2017, 37(12): 2912-2913. doi: 10.3969/j.issn.1005-9202.2017.12.022
    [6]
    ZHAO H, ZHAO X, LIU X, et al. Association of carotid atherosclerotic plaque features with acute ischemic stroke: A magnetic resonance imaging study[J]. European Journal of Radiology, Elsevier Ireland Ltd, 2013, 82(9): e465-e470.
    [7]
    LATIMER J, BATTY J A, NEELY R D G, et al. PCSK9 inhibitors in the prevention of cardiovascular disease[J]. JThromb Thrombolysis, 2016, 42(3): 405-419. doi: 10.1007/s11239-016-1364-1
    [8]
    RASHID S, TAVORI H, BROWN P E, et al. Proprotein convertase subtilisin kexin type 9 promotes intestinal overproduction of triglyceride-rich apolipoprotein B lipoproteins through both low-density lipoprotein receptor-dependent and-independent mechanisms[J]. Circulation, 2014, 130(5): 431-441. doi: 10.1161/CIRCULATIONAHA.113.006720
    [9]
    TANG Z H, JIANG L, PENG J, et al. PCSK9 siRNA suppresses the inflammatory response induced by oxLDL through inhibition of NF-κB activation in THP-1-derived macrophages[J]. IntJMolMed, 2012, 30(4): 931-938.
    [10]
    KYSENIUS K, MUGGALLA P, MÄTLIK K, et al. PCSK9 regulates neuronal apoptosis by adjusting ApoER2 levels and signaling[J]. CellMol Life Sci, 2012, 69(11): 1903-1916.
    [11]
    APAIJAI N, MOISESCU D M, PALEE S, et al. Pretreatment with PCSK9 inhibitor protects the brain against cardiac ischemia/reperfusion injury through a reduction of neuronal inflammation and amyloid beta aggregation[J]. JAm Heart Assoc, 2019, 8(2): e010838. doi: 10.1161/JAHA.118.010838
    [12]
    LI J, LIANG X, WANG Y Y, et al. Investigation of highly expressed PCSK9 in atherosclerotic plaques and ox-LDL-induced endothelial cell apoptosis[J]. MolMedRep, 2017, 16(2): 1817-1825.
    [13]
    SHEN L, PENG H C, NEES S N, et al. Proprotein convertase subtilisin/kexin type 9 potentially influences cholesterol uptake in macrophages and reverse cholesterol transport[J]. FEBS Lett, 2013, 587(9): 1271-1274. doi: 10.1016/j.febslet.2013.02.027
    [14]
    NAVARESE E P, KOLODZIEJCZAK M, WINTER M P, et al. Association of PCSK9 with platelet reactivity in patients with acute coronary syndrome treated with prasugrel or ticagrelor: the PCSK9-REACT study[J]. IntJCardiol, 2017, 227: 644-649.
    [15]
    CAMMISOTTO V, PASTORI D, NOCELLA C, et al. PCSK9 regulates Nox2-mediated platelet activation via CD36 receptor in patients with atrial fibrillation[J]. Antioxidants, 2020, 9(4): 1-14.
    [16]
    PASTORI D, NOCELLA C, FARCOMENI A, et al. Relationship of PCSK9 and urinary thromboxane excretion to cardiovascular events in patients with atrial fibrillation[J]. JAmCollCardiol, 2017, 70(12): 1455-1462.
    [17]
    WANG H, WANG Q, WANG J, et al. Proprotein convertasesubtilisin/kexin type 9 (PCSK9) Deficiency is Protective Against Venous Thrombosis in Mice[J]. Scientific Reports, Springer US, 2017, 7(1): 1-8. doi: 10.1038/s41598-016-0028-x
    [18]
    SHARMA S, MAZYA M V, WAHLGREN N, et al. IV thrombolysis in very severe and severe ischemic stroke: results from the SITS-ISTR Registry[J]. Neurology, 2016, 86(22): 2115.
    [19]
    ALI K, CHEEK E, SILLS S, et al. Development of a conversion factor to facilitate comparison of National Institute of Health Stroke Scale scores with Scandinavian Stroke Scale scores[J]. CerebrovascDis Basel Switz, 2007, 24(6): 509-515.
    [20]
    ALMONTASHIRI N A M, VILMUNDARSON R O, GHASEMZADEH N, et al. Plasma PCSK9 levels are elevated with acute myocardial infarction in two independent retrospective angiographic studies[J]. Plos One, 2014, 9(9): 1-9.
    [21]
    CHENG J M, OEMRAWSINGH R M, GARICIA-GARICIA H M, et al. PCSK9 in relation to coronary plaque inflammation: Results of the ATHEROREMO-IVUS study[J]. Atherosclerosis, Elsevier Ltd, 2016, 248: 117-122.
  • Related Articles

    [1]TIAN Xueqin, WANG Jiahao, JI Linling, ZHAO Gege, JIANG Jing, WANG Yingge. Correlations of plasma cyclin-dependent kinase 9 level with disease progression and prognosis in patients with acute large artery atherosclerotic cerebral infarction[J]. Journal of Clinical Medicine in Practice, 2025, 29(1): 6-12. DOI: 10.7619/jcmp.20243593
    [2]BAO Qingying, ZHANG Lingling, MA Songhua, CHEN Xiaobo, JIANG Zhi, JIANG Qiqun. Correlations between serum soluble growth stimulationgene 2 protein, brain natriuretic peptide and the degree of carotid atherosclerosis in patients with acute ischemic stroke[J]. Journal of Clinical Medicine in Practice, 2024, 28(8): 70-74, 78. DOI: 10.7619/jcmp.20240200
    [3]ZHANG Benyin, LU Wuzhang, YANG Jing. Relationships of National Institutes of Health Stroke Scale score, plasma homocysteine level with acute cerebral infarction and analysis in related risk factors[J]. Journal of Clinical Medicine in Practice, 2021, 25(22): 102-105. DOI: 10.7619/jcmp.20212001
    [4]CAO Lan, TAO Yujian, ZHAO Yuanlu, ZHANG Pan. Analysis in risk factors of solitary pulmonary nodules[J]. Journal of Clinical Medicine in Practice, 2021, 25(1): 38-40, 44. DOI: 10.7619/jcmp.20200457
    [5]YANG Li, SUN Xiaohui, HE Jing, WU Yuliang. Influence of trimetazidine combined with clopidogrelon carotid atherosclerotic plaques and inflammatory factors of patients with coronary heart disease[J]. Journal of Clinical Medicine in Practice, 2019, 23(11): 20-23. DOI: 10.7619/jcmp.201911006
    [6]CHENG Liqun. Correlation between leukoaraiosis and cerebral infarction and risk factors[J]. Journal of Clinical Medicine in Practice, 2018, (7): 42-44. DOI: 10.7619/jcmp.201807011
    [7]SHI Guiwen. Risk factors of type 2 diabetes mellitus complicated with carotid atherosclerosis and analysis of neutrophil to lymphocyte ratio and platelets to lymphocyte ratio levels[J]. Journal of Clinical Medicine in Practice, 2018, (1): 27-30. DOI: 10.7619/jcmp.201801009
    [8]CHU Jie, DU Ping, HE Chen, WANG Fangbing, HAO Yingping. Value of apolipoprotein B/A-1 ratio combined with carotid plaque nature examination in predicting the risk of patients with coronary heart disease[J]. Journal of Clinical Medicine in Practice, 2017, (11): 35-37. DOI: 10.7619/jcmp.201711011
    [9]ZHANG Jifang. Research on occurrence of macrosomia and its related risk factors[J]. Journal of Clinical Medicine in Practice, 2014, (3): 116-118. DOI: 10.7619/jcmp.201403041
    [10]WEI Shiyou, WANG Yanlin. Study on risk factors for relapse of stroke in young people[J]. Journal of Clinical Medicine in Practice, 2013, (17): 16-19. DOI: 10.7619/jcmp.201317005
  • Cited by

    Periodical cited type(60)

    1. 蔡莉,杜桂芝. 多层面干预在无痛胃镜检查患者中的临床效果观察. 临床消化病杂志. 2024(04): 280-284 .
    2. 孟凡华. 协作式无缝隙全期护理模式辅助内镜下黏膜切除术治疗胃息肉的应用效果. 医学信息. 2023(04): 153-155 .
    3. 史娟双. 专科护士主导的可视化健康教育在无痛消化内镜检查中的应用价值. 黑龙江中医药. 2023(03): 175-177 .
    4. 崔希茹. 不同护理模式在无痛消化内镜检查术中的应用效果. 医学信息. 2022(05): 184-186 .
    5. 傅丽桑,杨媛萍,周秀花. 快速康复理念支持下的护理干预在全胃术后患者中的运用. 中外医疗. 2022(03): 137-141 .
    6. 王扬正,吴姗宏,招燕珍. 时空限制突破式交互教育平台在胃肠镜检查患者中的应用研究. 黑龙江医学. 2022(12): 1514-1516 .
    7. 施香兰. 预见性护理模式在胃肠镜检查风险控制中的应用. 医学信息. 2022(14): 190-192 .
    8. 文银霞. 以人性化理念为基础的综合护理在胃十二指肠镜检查中的应用. 黑龙江医药. 2022(04): 981-983 .
    9. 苏雪棠,梁健,周少丹. 医护麻三位一体安全管理措施对清醒镇静麻醉下无痛胃肠镜检查患者负性情绪及不良反应的影响. 吉林医学. 2022(11): 3135-3138 .
    10. 李爱敏,范素强,陈玉楠. 无痛胃镜检查中全程服务管理对患者情绪、复查依从性的影响. 河北医药. 2022(21): 3345-3347+3351 .
    11. 柏婷婷,王化明,耿晓菁,杨小峰,王旭璞. 针对性认知干预结合预见护理对胃肠镜下手术患者的干预效果. 现代中西医结合杂志. 2022(22): 3183-3186 .
    12. 黄金转. 腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石病人的护理观察. 疾病监测与控制. 2021(01): 52-54 .
    13. 孙薇. 心理护理干预在无痛胃肠镜检查中的应用分析. 心理月刊. 2021(05): 155-156 .
    14. 刘秀玉,任宪辉,侯信良,曾婷. 依托咪酯联合优质护理在无痛胃肠镜检查中的应用效果. 现代医学与健康研究电子杂志. 2021(13): 16-19 .
    15. 包萍,成敏,顾政. 护理安全管理措施在清醒镇静麻醉下无痛胃镜及肠镜检查患者中的应用效果. 国际护理学杂志. 2021(14): 2644-2647 .
    16. 张薇,石桂梅,王靓. 中医情志护理对行无痛胃镜检查患者麻醉效果及心理性疼痛的研究. 中国当代医药. 2021(26): 262-264+268 .
    17. 曾婷,朱洪春,侯信良,刘秀玉. 右美托咪定联合围手术期护理在无痛胃镜检查患者中的应用. 现代医学与健康研究电子杂志. 2021(17): 131-133 .
    18. 董洋洋. 优质护理服务在无痛胃肠镜检查中的实施. 中外医疗. 2021(24): 144-147 .
    19. 杨霞,何小霞,吴永萍,娄小敏. 探讨全程护理干预在无痛胃镜联合肠镜检查中的应用. 中国社区医师. 2021(32): 161-162+165 .
    20. 杨小敏,黄小洁,林雪华,曾楚云. 优质护理干预在无痛胃肠镜诊疗患者中的应用效果观察. 智慧健康. 2021(28): 150-152 .
    21. 潘锦梅. 流程化护理在无痛胃肠镜检查中的应用效果. 医学食疗与健康. 2021(10): 133-134 .
    22. 成洁. 全程护理干预对无痛胃镜检查患者负性情绪及并发症的影响. 医疗装备. 2020(01): 189-191 .
    23. 胡水娟,王雅琴,闫琴芬. 人性化沟通在缓解胃肠镜检查患者负性情绪中的应用. 齐鲁护理杂志. 2020(04): 108-110 .
    24. 万小艳. 全程优质护理配合支气管动脉栓塞对咳血患者病情转归及不良反应的影响. 医疗装备. 2020(05): 185-186 .
    25. 段鲁静,赵作静,王瑞,马建民. 优质护理干预对老年无痛胃肠镜诊疗术患者生命体征、情绪及不良反应的影响. 航空航天医学杂志. 2020(01): 96-98 .
    26. 刘丽芳. 全程整体护理在无痛胃肠镜诊疗胃肠疾病患者中的应用. 中西医结合心血管病电子杂志. 2020(04): 120 .
    27. 卓傲. PDCA模式在胃肠镜检查中护理风险控制的应用效果. 临床医药文献电子杂志. 2020(24): 124 .
    28. 林翠香,司徒丽萍,张宁,陈秀迎. 优质护理对接受无痛胃肠镜检查患者检查时间及并发症发生率的影响. 当代医药论丛. 2020(12): 218-219 .
    29. 曾海云. 优质护理在无痛胃肠镜诊疗患者中的应用研究. 中国医药指南. 2020(24): 15-16+19 .
    30. 毛红玲,吴杨玲,魏小飞,代浩,杨雪,付羽婷. 体位护理联合心理干预对无痛胃肠镜检查患者生命体征及心理状态的影响. 实用医院临床杂志. 2020(05): 193-195 .
    31. 葛耐耐. 语言沟通应用于无痛胃镜检查护理中对患者并发症发生率及满意度的影响. 中国社区医师. 2020(34): 134-135 .
    32. 张莉. 精细健康干预对行无痛胃肠镜诊疗患者的临床应用价值. 智慧健康. 2020(30): 156-157 .
    33. 吴诗虹. 优质护理干预在电子无痛胃肠镜诊疗中的应用效果. 临床合理用药杂志. 2019(03): 171-173 .
    34. 郑瑶珍,衷爱华,李春梦. 全程护理干预对无痛胃镜联合肠镜检查患者的效果. 中国医药科学. 2019(04): 127-129 .
    35. 黄冬梅. 舒适护理对无痛消化内镜检查患者心理状况及护理质量的影响. 名医. 2019(03): 210 .
    36. 李燕,谢娟,巫丽莎. 流程化护理干预对胃肠镜检查术患者负性心理的影响观察. 实用临床护理学电子杂志. 2019(11): 2-3 .
    37. 张小荣,卢伟丽. 综合心理护理在呼吸内镜治疗患者中的应用效果. 当代护士(中旬刊). 2019(09): 101-103 .
    38. 金笑笑. 全程护理在电子胃镜检查中的应用. 世界最新医学信息文摘. 2019(70): 367-368 .
    39. 陈斌斌,陈新妹. 围术期全程优质护理对无痛胃肠镜检查患者负性情绪及术中麻药用量的影响. 中外医学研究. 2019(26): 104-106 .
    40. 刘乃真,谢文吉. 健康教育联合心理护理在无痛胃镜中的护理干预效果. 中外医学研究. 2019(28): 83-85 .
    41. 赵云霞. 优质护理在无痛胃肠镜麻醉患者中的应用体会. 实用临床护理学电子杂志. 2019(42): 143 .
    42. 王丽君,顾晓燕. 优质护理对结肠癌患者围手术期护理效果的影响. 实用临床护理学电子杂志. 2019(41): 125 .
    43. 李艳艳. 对接受无痛肠镜检查的患者进行全程精细化护理的效果探讨. 当代医药论丛. 2019(19): 238-239 .
    44. 周峰. 对接受甲状腺肿瘤切除术的患者进行全程优质护理的效果探析. 当代医药论丛. 2019(22): 275-277 .
    45. 孟兴宇,孙婉婷. 对进行无痛胃肠镜检查的胃肠疾病患者实施优质护理的应用. 临床医药文献电子杂志. 2019(93): 155 .
    46. 周燕妮,闫琳. 优质护理带教法在无痛胃肠镜检查中的应用价值. 内蒙古医科大学学报. 2019(S2): 252-254 .
    47. 万敏. 对进行无痛胃肠镜检查的胃肠疾病患者实施优质护理的效果分析. 当代医学. 2018(19): 177-178 .
    48. 熊合明,金晓英. 综合护理干预对中青年结直肠镜检查患者心理状况的影响. 护理实践与研究. 2018(08): 152-154 .
    49. 刘善红,朱金早,谭金娉,罗子青,徐建晶. 探究在无痛胃肠镜诊疗中采用精细护理干预的效果. 护理实践与研究. 2018(15): 138-139 .
    50. 刘春燕,吴娟,吴慧娟. 全程整体护理应用于无痛胃肠镜诊疗胃肠疾病患者中的效果分析. 中外医疗. 2018(12): 155-157 .
    51. 罗子青,肖文鑫. 预见性护理在无痛胃肠镜麻醉患者中的应用. 内蒙古医学杂志. 2018(06): 759-760 .
    52. 刘佳. 全程护理干预对胃肠镜检查患者心理状态及生命体征的影响. 医疗装备. 2018(18): 172-173 .
    53. 孙国明,占文娟. 4R危机管理模式在无痛胃肠镜检查风险管理中的应用. 中医药管理杂志. 2018(17): 164-165 .
    54. 王军花,张利,周艳. 流程化护理干预对胃肠镜检查术患者心理的影响. 中国现代药物应用. 2018(22): 164-165 .
    55. 赵君君. 对接受无痛胃肠镜检查的患者进行预警性护理的效果评价. 当代医药论丛. 2018(21): 254-255 .
    56. 温林芳. 围手术期全程优质护理在无痛胃肠镜检查患者中的应用. 医疗装备. 2018(23): 197-198 .
    57. 段旭娟. 强化心理护理联合健康指导在无痛胃肠镜检查前中的应用. 中西医结合心血管病电子杂志. 2018(35): 141-142 .
    58. 李永霞. 全程护理对无痛胃镜检查患者生命体征及心理状态的影响评价. 心理月刊. 2018(11): 54 .
    59. 缪愿戍. 优质护理干预ICU肿瘤重症患者的效果评价. 中国继续医学教育. 2018(32): 170-172 .
    60. 常慧莉,韩俊萍. xx例无痛胃肠镜患者的护理管理分析. 中国妇幼健康研究. 2017(S4): 196-197 .

    Other cited types(1)

Catalog

    Article views (185) PDF downloads (17) Cited by(61)

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return