ABSTRACT
Objective To investigate the role of the combination of alpha2-heremans-schmid glycoprotein (AHSG) , tumor necrosis factor-α (TNF-α) , and interleukin-1 β (IL-1β) in detecting carotid vulnerable plaque in patients with acute cerebral infarction (ACI). Methods A total of 136 ACI patients were enrolled. According to the carotid ultrasound results, patients were assigned into the stable plaque group (n = 57) and vulnerable plaque group (n = 79). And their clinical data were collected. Logistic regression analyses were performed to identify independent risk factors of carotid vulnerable plaque in ACI patients. Receiver operating characteristic (ROC) was used to explore the diagnostic efficacy of AHSG, TNF-α, IL-1β and their combination in detecting carotid vulnerable plaque. Results (1) AHSG level of vulnerable plaque group was significantly lower than that of stable plaque group (P < 0.05) , while the levels of TNF-α and IL-1β of vulnerable plaque group were higher than those of stable plaque group. (2) Multivariate logistic regression analyses revealed that hypertension (OR = 1.257, 95％CI: 1.017～ 1.554) , type 2 diabetes (OR=1.474, 95％ CI: 1.048 ～2.074) , AHSG (OR= 0.510, 95％ CI:0.287 ～0.920) , TNF-α (OR = 1.020, 95％CI: 1.006 ～1.029) and IL-1β (OR= 1.484, 95％CI: 1.067 ～2.062) were independent risk factors of carotid vulnerable plaque. (3) ROC curves revealed that the area under the curve (AUC) of AHSG combined with TNF-α and IL-1β detecting carotid vulnerable plaque was 0.903 (95％CI: 0.840～0.947) , with sensitivity of 89.87％ and specificity of 75.44％, which was significantly superior to that of three individual biomarker (P < 0.05). Conclusions AHSG, TNF-α and IL-1β are independent risk factors of carotid vulnerable plaque in ACI patients, and their combination has the highest predictive efficacy which is of high clinical significance.