血浆可溶性CD40配体、甲胎球蛋白和妊娠相关血浆蛋白-A与缺血性卒中患者颈动脉斑块的关系  

Relationships between plasma soluble CD40 ligand, fetuin-A and pregnancy-associated plasma protein A and carotid artery plaque in patients with iscbemic stroke

作　　者：毕显梅[1] 许庭斌 于敦波[1] 刘坤[1] 王永久[1] 

机构地区：[1]青岛市第八人民医院神经内科,266100

出　　处：《国际脑血管病杂志》2013年第8期612-617,共6页International Journal of Cerebrovascular Diseases

摘　　要：目的探讨急性缺血性卒中患者血浆可溶性CIMO配体（soluble CD40 ligand，sCD40L）、甲胎球蛋白和妊娠相关血浆蛋白-A（preglancy associated plasma protein—A，PAPP—A）水平与颈动脉斑块的关系。方法纳入急性缺血性卒中患者。采用颈动脉超声对颈动脉进行评估，根据评估结果分为颈动脉斑块组和非颈动脉斑块组，前者根据斑块性质进一步分为稳定斑块亚组和不稳定斑块亚组。采用酶联免疫吸附法检测血浆sCIMOL、甲胎球蛋白和PAPP—A水平。对颈动脉斑块组与非颈动脉斑块组以及稳定斑块亚组与不稳定斑块亚组之间的人口统计学、既往史、合并症、实验室检查和血浆炎性标记物进行比较。采用多变量logistic回归分析探讨血浆炎性标记物与颈动脉斑块的关系。结果共纳入200例急性缺血性卒中患者。其中，男性122例，女性78例，年龄33～87岁，平均（60．1±10．3）岁；颈动脉斑块组139例，非斑块组61例；稳定斑块亚组43例，不稳定斑块亚组96例。颈动脉斑块组平均年龄显著性大于非斑块组[（63．2±8．7）岁对（50．3±9．5）岁；t=10．179，P=0．000]，男性（68．3％对44．3％；X2=10．336，P=0．001）、高血压（71．2％对54．1％；X2=5．540，P=0．019）、糖尿病（46．8％对29．5％；X2=5．199，P=0．023）和高脂血症（78．4％对37．7％；X2=31．31，P=0．000）患者的构成比显著性高于非斑块组，总胆固醇[（5．7±1．1）mmol／L对（5．3±1．0）mmol／L；t=2．433，P=0．0161、低密度脂蛋白胆固醇[（4．5±1．0）mmol／L对（4．1±0．9）mmol／L；t=2．683，P=0．008]和空腹血糖[（7．5±2．5）mmol／L对（6．4±2．1）mmol／L；t=3．002，P=0．003]以及sCD40L[（151．4±55．8）pg/ml 对（102．8±65．9）pg／ml；t=5．360，P=0．000]、甲胎球蛋白[（390．1±80．6）μg/ml 对（352．9±98．6）μg/ml；t=2．591，P=0．011]和PAPP—A[（11�Objective To investigate the relationships between the levels of plasma soluble CD40 liand （sCD40L）, fetuin-A and pregnancy-associated plasma protein A （PAPP-A） and carotid plaque in patients with acute ischemic stroke. Methods The patients with acute ischemic stroke were enrolled in the study. Carotid arteries were assessed by using carotid artery ultrasound. The patients were divided into either a carotid artery plaque group or a non-carotid artery plaque group according to the assessment results. The former were further divided into a stable plaque sub-group and an unstable plaque sub-group according the nature of plaque. Enzyme-linked immunosorbent assay was used to detect the levels of plasma sCD40L, fetuin-A and PAPP-A. The demography, previous history, complications, laboratory tests and plasma inflammatory biomarkers between the carotid artery plaque group and the non-carotid artery plaque group and between the stable plaque subgroup and the unstable plaque subgroup were compared. Multivariate logistic regression analysis was used to investigate the relationship between plasma inflammatory biomarkers and carotid plaques. Results A total of 200 patients with acute ischemic stroke were included. Among them, 78 were females and 122 were males （aged 33 to 87 years, mean 60. 1 ± 10. 3 years）; 139 patients were in the carotid artery plaque group and 61 were in the non-plaque group; 43 were in the stable plaque subgroup and 96 were in the unstable plaque subgroup. The mean age of the carotid artery plaque subgroup was significantly greater than that in the non-plaque subgroup （63.2 ± 8. 7 years vs. 50. 3 ± 9. 5 years; t = 10. 179, P =0. 000）, the constituent ratios of men （68. 3% vs. 44.3%;X2 = 10.336, P= 0.001）, hypertension （71.2% vs. 54. 1%; X2 = 5.540, P= 0.019）, diabetes （46. 8% vs. 29. 5% ;X2 =5. 199, P =0. 023）, and hyperlipidemia （78. 4% vs. 37. 7% ;X2 =31.31, P =0. 000） in patients of carotid plaque group were significantly higher than those of the non-carotid plaque g

关 键 词：卒中 脑缺血 颈动脉疾病 斑块 动脉粥样硬化 CD40配体 α-2-HS-糖蛋白 妊娠相关血浆蛋白A 

分 类 号：R743.3[医药卫生—神经病学与精神病学]