【摘要】 目的：探讨围绝经期妇女血清同型半胱氨酸（Hcy），高密度脂蛋白胆固醇（HDL-C）和脂蛋白（a）[Lp(a)]的表达与颈动脉斑块形成关系。方法：纳入2020年1月-2024年12月于本院就诊的围绝经期妇女153例临床资料，根据颈动脉超声结果分为斑块组（n=52）和非斑块组（n=101），收集两组临床资料并比较两组血清Hcy、HDL-C和Lp(a)水平，采用多因素logistic回归分析颈动脉斑块形成的影响因素，采用受试者工作特征（ROC）曲线分析Hcy、HDL-C和Lp(a)对围绝经期妇女颈动脉斑块形成的预测价值。结果：153例围绝经期妇女中，颈动脉斑块检出率为34.0%。斑块组年龄、体质指数（BMI）、潮热占比、TC、LDL-C水平均高于非斑块组，血清Hcy、Lp(a)水平均高于非斑块组，HDL-C水平低于非斑块组（均P<0.05）；多因素logistic回归分析，年龄大、BMI高、潮热、TC高、LDL-C高、Hcy高、Lp(a)高是围绝经期妇女颈动脉斑块形成的危险因素，HDL-C高是围绝经期妇女颈动脉斑块形成的保护因素（均P<0.05）；受试者工作特征曲线分析，围绝经期妇女Hcy、HDL-C、Lp(a)对颈动脉斑块形成具有预测价值，且联合预测的曲线下面积（0.882）高于各指标单独应用（0.735、0.759、0.781），此时的灵敏度75.0%、特异度91.1%。结论：Hcy升高、Lp(a)升高是围绝经期妇女颈动脉斑块形成的独立危险因素，HDL-C升高是保护因素，三者联合预测围绝经期妇女颈动脉斑块的形成具有较高的价值。更多还原

【Abstract】 Objective:To explore the correlation between the levels of the serum homocysteine(Hcy),high-density lipoprotein cholesterol(HDL-C)and lipoprotein(a)expressions of perimenopausal women and their carotid artery plaque formation.Methods:The clinical data of 153 perimenopausal women who visited the hospital from January 2020 to December 2024 were included in this study.These women were divided into group A(52 cases with plaque formation)and group B(101 cases without plaque formation)based on their carotid artery ultrasound results.The clinical data of the women from both groups were collected,and the levels of the serum Hcy,HDL-C and Lp(a)of the women were compared between the two groups.Multivariate logistic regression analysis was used to identify the influencing factors of the carotid plaque formation of the women.Receiver operating characteristic(ROC)curve analysis was employed to assess the predictive values of the levels of Hcy,HDL-C and Lp(a)of the perimenopausal women for their carotid plaque formation.Results:The detection rate of the carotid artery plaques of the perimenopausal women was 33.4%.The age,the body mass index(BMI),the proportion of hot flashes,and the TC and LDL-C levels of the women in group A were significantly higher than those of the women in group B.The serum Hcy and Lp(a)levels of the women in group A were also significantly higher than those of the women in group B,while the HDL-C level of the women in group A was significantly lower than that of the women in group B(all P<0.05).Multivariate logistic regression analysis showed that the advanced age,the higher BMI,the hot flashes,the higher levels of TC,LDL-C,Hcy and Lp(a)of the perimenopausal women were the risk factors of their carotid plaque formation,while the higher HDL-C level of the women was a protective factor(all P<0.05).ROC curve analysis indicated that the levels of Hcy,HDL-C and Lp(a)of the perimenopausal women had predictive values for their carotid plaque formation,and the area under the curve of the combined Hcy,HDL-C and Lp(a)levels of the women for predicting their carotid plaque formation was 0.882,which was significantly higher than that(0.735,0.759 or 0.781)of Hcy level,HDL-C level or Lp(a)level alone.The sensitivity and the specificity of the combined Hcy,HDL-C and Lp(a)levels of the women for predicting their carotid plaque formation were 75.0% was 91.1%.Conclusion:The increase of the Hcy and Lp(a)levels of the perimenopausal women are the independent risk factors of their carotid plaque formation,while the increase of the HDL-C level is a protective factor.The combination of the Hcy,HDL-C and Lp(a)levels of the women for predicting their carotid plaque formation has significant value.更多还原