摘要：

目的 探讨血清γ-谷氨酰转移酶（GGT）表达变化与颈动脉粥样硬化斑块稳定性的关系。方法 根据颈动脉超声结果将1032 例颈动脉斑块患者分为稳定型斑块组（511 例）和不稳定型斑块组（521 例），单因素和多因素前进法Logistic 回归分析筛查不稳定型斑块危险因素。结果 与稳定型斑块组相比，不稳定型斑块组男性（P = 0.000）和吸烟史（P = 0.000）比例，以及血清甘油三酯（TG，P = 0.002）、低密度脂蛋白胆固醇（LDL-C，P = 0.008）和GGT（P = 0.000）水平升高，年龄（P = 0.002）和血清高密度脂蛋白胆固醇（P = 0.032）水平降低。Logistic 回归分析显示，性别（OR = 1.516，95%CI：1.170 ~ 1.964；P = 0.002）、吸烟史（OR = 1.447，95%CI：1.085 ~ 1.930；P = 0.012），以及血清TG（OR = 1.127，95%CI：1.032 ~ 1.231；P = 0.008）、LDL-C（OR = 1.235，95%CI：1.069 ~ 1.426；P = 0.004）和GGT（OR = 1.012，95%CI：1.006 ~ 1.019；P = 0.000）是颈动脉不稳定型斑块的独立危险因素。结论 血清GGT 水平升高是颈动脉不稳定型斑块的危险因素。

关键词: 动脉粥样硬化, 颈动脉疾病, γ-谷氨酰转移酶, 危险因素, 回归分析

Abstract:

Objective  To investigate the relation between the level of serum γ-glutamyltransferase (GGT) and the stability of carotid atherosclerotic plaque.  Methods  A total of 1032 patients with carotid atherosclerotic plaques were divided into stable plaque group (N = 511) and unstable plaque group (N = 521) according to the results of carotid artery Doppler ultrasound examination. Risk factors for unstable carotid plaques were screened by univariate and multivariate forward Logistic regression analysis.  Results  Compared with patients with stable plaques, percentage of males (P = 0.000), proportion of smoking history (P = 0.000), the serum levels of triglyceride (TG, P = 0.002), low-density lipoprotein cholesterol (LDL-C, P = 0.008) and GGT (P = 0.000) increased significantly, while age (P = 0.000) and serum high-density lipoprotein cholesterol level (HDL-C, P = 0.032) decreased significantly in patients with unstable plaques. Univariate and multivariate forward Logistic regression analysis showed that sex (OR = 1.516, 95%CI: 1.170-1.964; P = 0.002), smoking history (OR = 1.447, 95% CI: 1.085-1.930; P = 0.012), serum TG (OR = 1.127, 95% CI: 1.032-1.231; P = 0.008), serum LDL-C (OR = 1.235, 95%CI: 1.069-1.426; P = 0.004) and serum GGT (OR = 1.012, 95%CI: 1.006-1.019; P = 0.000) were independent risk factors for the occurrence of unstable carotid plaques.  Conclusions  Elevation of serum GGT level is a risk factor for unstable carotid plaques.

Key words: Atherosclerosis, Carotid artery diseases, Gamma-glutamyltransferase, Risk factors, Regression analysis