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目的:研究2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清前蛋白转化酶枯草溶菌素9(proprotein convertase subtilisin/kexin 9,PCSK9)与动脉粥样硬化(atherosclerosis,AS)指标的相关性。方法 :对351例T2DM患者进行病史采集、颈部及下肢血管彩色多普勒检查,测定其PCSK9水平。结果:T2DM合并AS组患者的血清PCSK9水平高于T2DM无AS组(P<0.05),血清PCSK9水平与T2DM患者的颈总动脉内中膜厚度(carotid artery intima-media thickness,CIMT)呈正相关(P<0.01),与右侧颈总动脉(RCCA)内径、RCCA峰值/次峰值(PI)、右侧颈内动脉(RICA)PI、左侧颈总动脉(LCCA)PI、左侧颈内动脉(LICA)PI、RICA阻力指数(RI)、LCCA RI等颈动脉粥样硬化相关性指标呈正相关(P<0.05),而与RCCAVmax、RCCA Vmin、RCCA Tamx等指标呈负相关(P<0.05)。结论 :T2DM患者血清PCSK9水平与评估AS程度的指标密切相关,可能成为临床预测及评估T2DM患者AS相关大血管疾病发生风险的指标。
OBJECTIVE: To investigate the correlation between serum pro-protein convertase subtilisin 9 (PCSK9) and atherosclerosis (AS) in type 2 diabetes mellitus (T2DM) patients. Methods: 351 cases of T2DM patients were collected history, neck and lower extremity vascular color Doppler examination, measured PCSK9 levels. Results: Serum PCSK9 levels in patients with T2DM complicated with AS were significantly higher than those without T2DM (P <0.05), and serum PCSK9 levels were positively correlated with carotid artery intima-media thickness (CIMT) in patients with T2DM (RCCA), RCCA peak / minor peak (PI), right internal carotid artery (RICA) PI, left common carotid artery (LCCA) PI, left internal carotid artery (LICA) PI, RICA resistance index (RI) and LCCA RI were positively correlated with carotid atherosclerosis (P <0.05), but negatively correlated with RCCAVmax, RCCA Vmin and RCCA Tamx (P <0.05) . Conclusion: Serum level of PCSK9 in T2DM patients is closely related to the assessment of the degree of AS, and may be an index for clinical prediction and assessment of the risk of AS-related macrovascular disease in T2DM patients.