血清C反应蛋白水平与缺血性卒中或短暂性脑缺血发作患者颈动脉粥样硬化斑块钙化的相关性  

Correlation between serum C-reactive protein level and carotid atherosclerotic plaque calcification in patients with ischemic stroke or transient ischemic attack

作　　者：张海侠[1] 陈响亮[1] 肖露露[1] 叶瑞东[1] 刘新峰[1] 

机构地区：[1]南京大学医学院临床学院南京军区南京总医院神经内科,210002

出　　处：《国际脑血管病杂志》2015年第11期820-823,共4页International Journal of Cerebrovascular Diseases

基　　金：国家青年科学基金项目（31300900）

摘　　要：目的探讨血清C反应蛋白（C-reactive protein，CRP）水平与缺血性卒中或短暂性脑缺血发作（transient ischemic attack，TIA）患者颈动脉粥样硬化斑块钙化的相关性。方法前瞻性纳入行头颈部血管CTA检查且距离发病时间为1～6个月的前循环非心源性缺血性卒中或T1A患者，收集人口统计学和临床资料，检测血清CRP水平，采用单变量和多变量logistic回归分析确定血清CRP水平与颈动脉粥样硬化斑块钙化的相关性。结果共纳入165例患者，年龄（62．4±10．6）岁，男性约占66．7％；113例（68．5％）存在颈动脉粥样硬化斑块钙化（钙化组），52例（31．5％）无颈动脉粥样硬化斑块钙化（无钙化组）。钙化组年龄（中位数，四分位间距）[66（58～73）岁对58（51～66）岁；Z=-3．738，P〈0．001l和CRP水平[1．9（0．5～3．8）mg／L对0．0（0．0～2．2）mg／L；Z=-4．126，P〈0．001]均显著高于无钙化组，其他基线临床资料差异均无统计学意义。多变量logistic回归分析显示，在校正其他混杂因素后，年龄（优势比1．063，95％可信区间1．024～1．104；P=0．001）和CRP水平（优势比1．209，95％可信区间1．030～1．419；P=0．020）仍然与斑块钙化显著独立相关性。结论缺血性卒中或TIA患者颈动脉斑块钙化与年龄较大和血清CRP水平增高相关。Objective To investigate the correlation between serum C-reactive protein （CRP） level and carotid atherosclerotic plaque calcification in patients with ischemic stroke or transient ischemic attack （TIA）. Methods The patients with non-cardiogenic ischemic stroke or TIA in anterior circulation performed head and neck vascular CTA at 1 - 6 months from the time of onset were enrolled prospectively. The demographic and clinical data were collected and serum CRP levels were detected. Univariate and multivariate logistic regression analyses were used to determine the correlation between the serum CRP level and the carotid atherosclerotic plaque calcification. Results A total of 165 patients were enrolled. Their age was 62.4±10.6years, male patients accounted for 66.7%; 113 patients （68.5%） had carotid atherosclerotic plaque calcification （calcification group）, 52 （31.5%） did not have carotid atherosclerotic plaque calcification （non-calcification group）. The age of the calcification group （median, interquartile; 66 [58-73] yearsvs. 58 [51- 66] years; Z= -3.738, P〈 0.001） and CRP levels （1.9 [0.5- 3.8] mg/Lvs. 0.0 [0.0-2.2] mg/L; Z= -4. 126, P〈0.001） were significantly higher than those of the non-calcification group. There were no significant differences in other baseline clinical data between the two groups. Multivariate logistic regression analysis showed that age （odds ratio 1. 063, 95% confidence interval 1.024-1. 104; P=0. 001） and CRP levels （odds ratio 1.209, 95% confidence interval 1. 030-1. 419; P = 0. 020） were still significantly correlated with the plaque calcification after adjusting for other confounding factors. Conclusions Carotid plaque calcification was correlated with older age and increased serum CRP level in patients with ischemic stroke or TIA.

关 键 词：卒中 脑缺血 脑缺血发作 短暂性 颈动脉疾病 C-反应蛋白质 钙质沉着症 斑块 动脉粥样硬化 体层摄影术 x线计算机 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]