中国麻风皮肤病杂志 ›› 2026, Vol. 42 ›› Issue (11): 779-785.doi: 10.12144/zgmfskin202611779

• 论著 • 上一篇    下一篇

重度斑块状银屑病患者外周血DRP1、FABP5的表达及与颈动脉粥样硬化的关系分析

马雪莹,兰海龙,周静,王晓磊,王正想   

  1. 沧州市人民医院皮肤科，河北沧州，061000
  • 出版日期:2026-11-15 发布日期:2026-10-29

Expression of DRP1 and FABP5 in peripheral blood of patients with severe plaque psoriasis and their relationship with carotid atherosclerosis

MA Xueying, LAN Hailong, ZHOU Jing, WANG Xiaolei, WANG Zhengxiang   

  1. Department of Dermatology, Cangzhou People's Hospital, Cangzhou 061000, China
  • Online:2026-11-15 Published:2026-10-29

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摘要： 目的：探讨外周血动力相关蛋白1（DRP1）、脂肪酸结合蛋白5（FABP5）在重度斑块状银屑病（SPP）患者中表达及其与颈动脉粥样硬化的关系分析。方法：前瞻性选取2023年1月至2025年5月我院收治的SPP患者158例（SPP组），另按照2∶1比例选取我院收治的轻度斑块状银屑病（PP）患者79例（轻度PP组）和中度PP患者79例（中度PP组），采用酶联免疫吸附法检测外周血DRP1、FABP5水平。根据是否发生颈动脉粥样硬化(CAS)将SPP患者分为CAS组和非CAS组，Pearson相关性分析SPP合并CAS患者外周血DRP1、FABP5水平与CIMT的相关性，多因素Logistic回归（输入法）及ROC曲线分析外周血DRP1、FABP5水平对SPP患者CAS的预测效能。1000次Bootstrap自助抽样法进行内部验证。结果：轻度PP组、中度PP组、SPP组外周血DRP1、FABP5水平依次升高（P＜0.017）。158例SPP患者CAS发生率为44.94%（71/158）。单因素分析显示，银屑病病程、银屑病病变面积及严重程度指数（PASI）、糖尿病、低密度脂蛋白胆固醇（LDL-C）、超敏C反应蛋白（hs-CRP）、DRP1、FABP5与SPP患者CAS有关（P＜0.05）。SPP合并CAS患者外周血DRP1、FABP5水平与CIMT呈正相关（r＝0.710、0.713，均P＜0.001）。银屑病病程延长（OR＝1.155，95% CI：1.032～1.292，P＝0.012）、LDL-C升高（OR＝4.462，95% CI：1.623～12.269，P＝0.004）、hs-CRP升高（OR＝1.381，95% CI：1.131～1.386，P＝0.002）、DRP1升高（OR＝1.467，95% CI：1.190～1.807，P＜0.001）、FABP5升高（OR＝1.614，95% CI：1.282～2.034，P＜0.001）为SPP患者CAS的独立危险因素。外周血DRP1、FABP5水平及二者联合预测SPP患者CAS的ROC曲线下面积分别为0.802、0.784、0.876，敏感度分别为0.578、0.535、0.718，特异度分别为0.862、0.943、0.885，二者联合预测效能优于外周血DRP1、FABP5水平单独预测（P＜0.05）。经1000次Bootstrap自助抽样法内部验证，外周血DRP1、FABP5水平联合预测SPP患者CAS的C指数为0.876。结论：SPP患者外周血DRP1、FABP5水平升高，为CAS的独立危险因素，外周血DRP1、FABP5水平联合预测CAS的效能较高。

关键词: 重度斑块状银屑病, 动力相关蛋白1, 脂肪酸结合蛋白5, 颈动脉粥样硬化

Abstract: Objective: To investigate the expression of peripheral blood dynamics related protein 1 (DRP1) and fatty acid binding protein 5 (FABP5) in patients with severe plaque psoriasis (SPP) and their relationship with carotid atherosclerosis. Methods: A total of 158 patients with SPP who were admitted to our hospital from January 2023 to May 2025 were prospectively enrolled as the SPP group. In addition, 79 patients with mild plaque psoriasis (PP) and 79 patients with moderate PP who were admitted during the same period were selected at a ratio of 2∶1 and assigned to the mild PP group and moderate PP group, respectively. Peripheral blood levels of DRP1 and FABP5 were measured by enzyme-linked immunosorbent assay. According to the presence or absence of CAS, patients with SPP were divided into the CAS group and non-CAS group. Pearson correlation analysis was performed to assess the correlations of peripheral blood DRP1 and FABP5 levels with CIMT in SPP patients with CAS. Multivariate Logistic regression analysis (enter method) and receiver operating characteristic (ROC) curves were used to evaluate the predictive value of peripheral blood DRP1 and FABP5 levels for CAS in patients with SPP. Internal validation was performed using 1,000 bootstrap resamples. Results: Serum DRP1 and FABP5 levels progressively increased across the mild PP, moderate PP, and SPP groups (P＜0.017). The incidence of CAS in SPP patients was 44.94% (71/158). Univariate analysis showed that psoriasis duration, psoriasis area and severity index (PASI), diabetes, low-density lipoprotein cholesterol (LDL-C), high-sensitivity C-reactive protein (hs-CRP), DRP1, and FABP5 were associated with CAS in SPP patients (P＜0.05). Serum DRP1 and FABP5 levels were positively correlated with CIMT in SPP patients with CAS (r＝0.710, 0.713, Ps＜0.001). Multivariate logistic regression revealed that longer disease duration (OR＝1.155, 95%CI: 1.032-1.292, P＝0.012), elevated LDL-C (OR＝4.462, 95%CI: 1.623-12.269, P＝0.004), increased hs-CRP (OR＝1.381, 95%CI: 1.131-1.386, P＝0.002), higher DRP1 (OR＝1.467, 95%CI: 1.190-1.807, P＜0.001), and higher FABP5 (OR＝1.614, 95%CI: 1.282-2.034, P＜0.001) were independent risk factors for CAS in SPP patients. The AUCs of DRP1, FABP5, and their combination for predicting CAS in SPP were 0.802, 0.784, and 0.876, respectively, with sensitivities of 0.578, 0.535, and 0.718, and specificities of 0.862, 0.943, and 0.885. Combined detection showed higher diagnostic efficiency compared with either marker alone (P＜0.05). Internal validation with 1,000 bootstrap resamples yielded a C-index of 0.876 for the combined DRP1 and FABP5 model in diagnosing CAS in patients with SPP. Conclusion: Elevated peripheral blood DRP1 and FABP5 levels are independent risk factors for CAS in SPP patients. The combined detection of DRP1 and FABP5 provides superior diagnostic performance compared with either marker alone.

Key words: severe plaque psoriasis, dynamin-related protein 1, fatty acid-binding protein 5, carotid atherosclerosis