Abstract: Background　Detection of atherosclerosis in the elderly can assess the risk of cardiovascular and cerebrovascular diseases early and monitor the clinical efficacy.Transforming growth factor-beta 1（TGF-β1） and connective tissue growth factor（CTGF） have been identified as key factors of tissue fibrosis.However，there are little research on its correlation with vascular sclerosis in the elderly.Objective　To analyze the relationship between TGF-β1 and CTGF in elderly patients with atherosclerosis，and to explore the feasibility of using TGF-β1，CTGF combined with brachial-ankle pulse wave velocity（BaPWV） and carotid ultrasound as indexes for evaluating arterial vascular pathological changes and monitoring clinical efficacy in the elderly.Methods　A total of 134 elderly patients，who sought medical advice in Department of Geriatrics and Cardiology of Jiangyin People's Hospital from September 2017 to September 2018，were selected and divided into arteriosclerosis group（69 cases） and normal control group（65 cases） according to the standard of BaPWV or carotid ultrasound diagnosis of atherosclerotic plaque.The BMI，blood pressure，levels of total cholesterol（TC），triglyceride（TG），high density lipoprotein cholesterol（HDL-C），low density lipoprotein cholesterol（LDL-C），urea nitrogen（BUN），serum creatinine（Scr） and glycosylated hemoglobin（HbA1c） were compared between the two groups.Serum levels of TGF-β1 and CTGF were detected by enzyme-linked immunosorbent assay（ELISA）．The incidence of hypertension，diabetes mellitus，cerebrovascular disease and coronary heart disease were compared between the two groups.Results　Systolic blood pressure（SBP），mean arterial pressure（MAP），HbA1c and BaPWV in arteriosclerosis group were higher than those in control group（P<0.05）．There was no significant difference in the serum level of TGF-β1 between arteriosclerosis group and control group（Z=-1.499，
P=0.134），while the serum level of CTGF in arteriosclerosis group was significantly higher than that in control group（Z=-3.250，P=0.001）．The morbidities of hypertension，diabetes mellitus and cerebrovascular disease in arteriosclerosis group were significantly higher than those in normal control group（P<0.05），but there was no significant difference in the morbidity of coronary heart disease between the two groups（P>0.05）．Conclusion　The serum level of CTGF in elderly patients with arteriosclerosis increased significantly.Therefore，CTGF combined with BaPWV and carotid ultrasound can be used as indexes for evaluating arterial vascular pathological changes and monitoring clinical efficacy in the elderly.

Key words: Arteriosclerosis, Brachial-ankle pulse wave velocity, Transforming growth factor beta 1, Connective tissue growth factor, Aged

摘要： 背景　在老年人群中开展动脉硬化检测可以早期评估心脑血管疾病风险及监测临床疗效。血清转化生长因子β1（TGF-β1）及结缔组织生长因子（CTGF）已被证实为组织纤维化的关键因子，但其与老年人群血管硬化的相关性研究甚少。目的　分析老年动脉硬化患者与TGF-β1、CTGF之间的关系，探讨TGF-β1、CTGF联合臂踝脉搏波传导速度（BaPWV）及颈动脉超声作为老年人群动脉血管病变评估和临床疗效监测指标的可行性。方法　选取2017年9月—2018年9月在江阴市人民医院老年医学科及心血管内科就诊的134例老年患者，将BaPWV高出标准值20%或颈动脉超声诊断有粥样硬化斑块者纳入动脉硬化组，其余纳入对照组。其中动脉硬化组69例，对照组65例。比较两组体质指数、血压、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、尿素氮（BUN）、血肌酐（Scr）、糖化血红蛋白（HbA1c）水平。采用酶联免疫吸附试验（ELISA）检测血清TGF-β1、CTGF水平。并比较两组高血压、糖尿病、脑血管疾病及冠心病发病率情况。结果　动脉硬化组收缩压（SBP）、平均动脉压（MAP）、HbA1c、BaPWV均高于对照组（P<0.05）。动脉硬化组和对照组TGF-β1水平比较，差异无统计学意义（Z=-1.499，P=0.134）；动脉硬化组CTGF水平高于对照组（Z=-3.250，P=0.001）。两组冠心病发病率比较，差异无统计学意义（P>0.05）；动脉硬化组高血压、糖尿病、脑血管疾病发病率均高于对照组（P<0.05）。结论　老年动脉硬化患者血清CTGF水平明显升高，可利用CTGF联合BaPWV及颈动脉超声作为老年人群动脉血管病变评估和临床疗效监测的指标。

关键词: 动脉硬化；臂踝脉搏波传导速度；转化生长因子&beta, 1；结缔组织生长因子；老年人