血清抵抗素、脂联素、C反应蛋白水平变化与急性脑梗死患者颈动脉粥样硬化的相关性分析  

Correlation of serum resistin,adiponectin and C- reactive protein levels with carotid atherosclerosis in patients with acute cerebral infarction

作　　者：王少颖[1] 王青青[1] 李净兵[1] 朱见文[1] 徐素芝[1] 王莉迪 

机构地区：[1]河北省老年病医院神经内科,河北石家庄050011

出　　处：《临床和实验医学杂志》2015年第21期1774-1777,共4页Journal of Clinical and Experimental Medicine

基　　金：2011年河北省科技支撑计划项目(编号:11276133);课题名称:老年急性脑梗死患者颈动脉粥样硬化新危险因素的探讨

摘　　要：目的探讨血清抵抗素、脂联素、C反应蛋白(CRP)水平变化与急性脑梗死患者颈动脉粥样硬化的相关性。方法选取2011年11月至2013年7月收治的106例急性脑梗死患者为研究对象。检测患者入院时的血清抵抗素、脂联素及CRP水平;所有患者接受彩色多普勒超声检测颈动脉,记录颈动脉内-中膜厚度(IMT)、粥样硬化斑块数等;根据超声结果分为无斑块组、稳定斑块组和不稳定斑块组,同期另选50例体检健康者为对照组,比较各组相关指标的差异。结果不稳定斑块组收缩压(SDP)、舒张压(SBP)高于另外三组(P<0.05);不稳定斑块组空腹血糖(FPG)高于另外三组(P<0.05),血清抵抗素及CRP从对照组到不稳定性斑块组逐渐增高(P<0.05),而血清脂联素则逐渐降低(P<0.05);脑梗死病例组中的颈动脉硬化发生率、平均颈动脉斑块数、IMT高于对照组(P<0.05);Pearson线性相关性分析提示:血清抵抗素与CRP呈正相关(r=0.476,P<0.05),与IMT呈正相关(r=0.398,P<0.05),而与脂联素呈负相关(r=-0.514,P<0.05);脂联素与CRP(r=-0.367,P<0.05)及IMT(r=-0.597,P<0.05)呈负相关。多元逐步回归分析提示:血清抵抗素及CRP水平与IMT呈正相关(P<0.05),而脂联素则与其呈负相关(P<0.05);多因素非条件Logistic回归分析提示:SBP、血清抵抗素及CRP是颈动脉不稳定性斑块发生的高危因素,而脂联素则是其保护因素。结论血清抵抗素及CRP在急性脑梗死患者中显著升高,而脂联素降低,血清抵抗素及CRP与脑梗死颈动脉不稳定性斑块及IMT密切相关,而脂联素则可能具有抗炎功能而抑制粥样硬化形成的作用。Objective To explore the relationship between serum resistin,adiponectin and C - reactive protein（CRP）levels and carotid atherosclerosis in patients with acute cerebral infarction. Methods 106 cases of acute cerebral infarction patients in our hospital from November 2011 to July 2013 were selected as the research subjects. Serum resistin,adiponectin and CRP were detected in patients on admission. All patients received color doppler ultrasonic of carotid artery,and carotid intima - medial thickness（IMT）,number of atherosclerotic plaque were recorded. All patients were divided into no plaque group,stable plaque group and unstable plaque group according to the result of ultrasonic. Meanwhile,50 cases of healthy subjects were selected as control group. The differences between the related groups were compared. Results SDP,SBP and FPG of unstable plaque group were higher than those of the other three groups（ P ﹤ 0. 05）. Serum resistin and CRP levels gradually increased from the control to the unstable plaque group（ P ﹤ 0. 05）. However,serum adiponectin gradually decreased（ P ﹤ 0. 05）. Incidence of carotid atheroscle-rosis,average number of carotid plaques and IMT in cerebral infarction cases group,were higher than the control group（ P ﹤ 0. 05）. Pearson cor-relation analysis showed that serum resistin was positively correlated with CRP（ r = 0. 476,P ﹤ 0. 05）,and was positively correlated with IMT（ r = 0. 398,P ﹤ 0. 05）,and negatively correlated with adiponectin（ r = - 0. 514,P ﹤ 0. 05）. Adiponectin was negatively correlated with CRP （ r = - 0. 367,P ﹤ 0. 05）and IMT（ r = - 0. 597,P ﹤ 0. 05）. Multiple stepwise regression analysis showed that serum resistin and CRP level were positively correlated with IMT（ P ﹤ 0. 05）,whereas adiponectin was negatively correlated IMT（ P ﹤ 0. 05）. Multi - factor unconditioned logistic regression analysis showed that SBP,serum resistin and CRP were risk factors of instability carotid plaque,and adiponectin was the prot

关 键 词：脑梗死 抵抗素 脂联素 C 反应蛋白 颈动脉粥样硬化 不稳定性斑块 

分 类 号：R743.3[医药卫生—神经病学与精神病学]