正五聚蛋白3与缺血性卒中患者颈动脉狭窄的关系研究  

Correlation between Plasma PTX3 Level and Carotid Stenosis in Patients with Ischemic Stroke

作　　者：易立[1] 杨伊姝[1] 张婷婷[2] 陈彬[1] 汤劼 YI Li;YANG Yi-Shu;ZHANG Ting-Ting;CHEN Bin;TANG Jie(Department of Neurology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Radiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Neurosurgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学附属北京友谊医院神经内科,北京100050 [2]首都医科大学附属北京友谊医院放射科 [3]首都医科大学宣武医院神经外科

出　　处：《中国卒中杂志》2020年第5期522-526,共5页Chinese Journal of Stroke

基　　金：国家自然科学基金项目(81400959);首都医院大学附属北京友谊医院院启动项目(yyqdkt2018-24)。

摘　　要：目的通过分析急性缺血性卒中患者血浆正五聚蛋白3(pentraxin 3,PTX3)和凝集素样氧化型低密度脂蛋白受体-1(lectin-like oxidized low density lipoprotein receptor-1,LOX-1)与颈动脉狭窄的关系,探索PTX3在颈动脉狭窄形成过程中的作用。方法前瞻性连续纳入2019年1-8月于首都医科大学附属北京友谊医院神经内科治疗的急性缺血性卒中患者,收集患者的基线资料、头颅CTA、血脂、PTX3、LOX-1等检查结果。根据患者头颅CTA有无颈动脉狭窄分为颈动脉狭窄组和无颈动脉狭窄组;以狭窄程度为标准,将颈动脉狭窄组患者分为严重狭窄(≥50%)组和轻度狭窄(<50%)组。采用单因素分析和多因素Logistic回归分析颈内动脉狭窄的独立危险因素。结果共纳入102例患者,颈动脉狭窄组57例(55.9%),无颈动脉狭窄组45例(44.1%),颈动脉狭窄组中轻度狭窄32例(56.1%),严重狭窄25例(43.9%);颈动脉狭窄组的缺血性脑血管病家族史比例、LDL-C、PTX3及LOX-1水平均高于无颈动脉狭窄组(均P<0.05);严重狭窄组的PTX3、LOX-1及LDL-C水平均高于轻度狭窄组(均P<0.05)。多因素Logistic回归分析结果显示PTX3(OR 3.11,95%CI 2.11~4.58,P=0.007)、LOX-1(OR 5.47,95%CI 2.89~10.13,P=0.017)和LDL-C(OR 5.35,95%CI 2.45~10.65,P=0.021)水平升高是颈动脉狭窄发生的独立危险因素。结论血浆PTX3、LOX-1和LDL-C水平升高是颈动脉狭窄的独立危险因素。Objective To evaluate the association of plasma pentraxin 3(PTX3) level and carotid stenosis in patients with acute ischemic stroke(AIS).Methods Consecutive AIS patients who underwent head and neck CTA in Department of Neurology of Beijing Friendship Hospital, Capital Medical University were prospectively enrolled in this study. Baseline data were collected. Based on the CTA results, the patients were divided into carotid stenosis group and no carotid stenosis group. The carotid stenosis group was further divided into severe stenosis subgroup and moderate stenosis subgroup. Univariate and multivariate logistic regression analysis was performed to determine the independent risk factors for carotid stenosis.Results A total of 102 patients were included, with 57 cases(55.9%) in carotid stenosis group and 45 cases(44.1%) in no carotid stenosis group, and 32 cases(56.1%) in moderate stenosis subgroup and 25 cases(43.9%) in severe stenosis subgroup. The percentage of ischemic cerebrovascular disease history and plasma PTX3, LOX-1, and LDL-C levels were higher in carotid stenosis group than that in no carotid stenosis group(all P<0.05). The level of plasma PTX3, LOX-1 and LDL-C were higher in severe stenosis subgroup than that in moderate stenosis(all P<0.05). The multivariate logistic regression analysis showed that the level of plasma PTX3, LOX-1 and LDL-C were all independent risk factors for carotid stenosis(OR 3.11, 95%CI 2.11-4.58, P=0.007;OR 5.47, 95%CI 2.89-10.13, P=0.017;OR 5.35, 95%CI 2.45-10.65, P=0.021).Conclusions High level of plasma PTX3, LOX-1 and LDL-C were independent risk factors for carotid stenosis.

关 键 词：正五聚蛋白3 凝集素样氧化型低密度脂蛋白受体-1 低密度脂蛋白胆固醇 颈动脉狭窄 缺血性卒中 

分 类 号：R743.3[医药卫生—神经病学与精神病学]