The Diagnostic Value Of Endothelium-specific Molecule-1 In Carotid Artery Stenosis And Its Possible Mechanism

Objective:To observe the expression level of endothelium-specific molecule-1 in patients with carotid artery stenosis,and to explore the diagnostic value of endothelium-specific molecule-1 in patients with carotid artery stenosis and its possible related mechanism.Method:A total of 79 patients with cerebral infarction admitted to the Department of Neurology of our hospital from July 2020 to March 2021 were selected as the cerebral infarction group,and 49 patients without cerebral infarction admitted to the dizziness clinic of our hospital during the same period were selected as the non-cerebral infarction group.According to the degree of carotid artery stenosis,all subjects were divided into four subgroups:non-stenosis group,mild stenosis group,moderate stenosis group and severe stenosis group.Cranial MRI+DWI and CTA examinations of the aortic arch of head and neck were completed in all subjects.To gather all participants’ age,gender,history of hypertension,diabetes,smoking history,the degree of carotid stenosis,total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),glycosylated hemoglobin(Hb A1c),homocysteine(Hcy)and serum endocan clinical data.The indexes and serum endocan levels of the non-cerebral infarction group and the cerebral infarction group were compared for statistical differences,and the indexes and serum endocan levels of each subgroup were compared for statistical differences.Pearson or Spearman correlation analysis was used to analyze the correlation between each index and serum endocan,carotid artery stenosis and serum endocan.And receiver operating characteristic curve(ROC)was drawn to evaluate the diagnostic value of serum endocan level for carotid artery stenosis.Result:1 No cerebral infarction group and cerebral infarction in age,gender,history of hypertension,diabetes,smoking history,total cholesterol,triglyceride,low density lipoprotein cholesterol,high-density lipoprotein cholesterol,glycosylated hemoglobin,homocysteine and serum endocan differences had no statistical significance(P > 0.05),showed that cerebral infarction had no obvious effect on serum levels of endocan express itself.2 There were no statistically significant differences in age,gender,history of hypertension,history of diabetes,smoking history,Hb A1 c and homocysteine among the four subgroups(P > 0.05).There were statistical differences in the expression levels of total cholesterol,triglyceride,low density lipoprotein cholesterol,high density lipoprotein cholesterol and serum endocan among the 4 subgroups(P < 0.05).Further pair comparison of serum endocan expression levels in 4 subgroups showed statistically significant differences(P < 0.05),and the serum endocan level gradually increased with the increase of the degree of stenosis.3 Spearman correlation analysis showed that serum endocan(r=0.645,P<0.001)was positively correlated with the degree of carotid artery sten osis.Pearson correlation analysis showed total cholesterol(r=0.466,P<0.001),triglyceride(r=0.382,P<0.001),low density lipoprotein cholesterol(r=0.477,P<0.001)was positively correlated with endocan,and high densitylipoprotein cholesterol(r=-0.369<0.001)was negatively correlated with serum endocan.4 The results of ROC curve analysis showed that the cutoff value of Endocan for predicting carotid artery stenosis was 1.185ng/ml,and the area under the ROC curve was 0.844(95%CI :0.76～0.93),with a sensitivity of73.7% and specificity of 83.3%.Conclusion:1 With the increase of the degree of carotid artery stenosis,the expression of endocan in serum also increases.There was a positive correlation.2 Serum endocan was positively correlated with TG and LDL-C,and negatively correlated with HDL-C.It is speculated that there may be certain interaction between endocan and blood lipids,and they are involved in the formation of atherosclerosis together.3 Serum endocan has a certain diagnostic value for carotid artery stenosis,which can provide an objective and simple diagnostic method for the early detection of carotid artery stenosis,and provide a basis for its early intervention.