炎性指标与老年矽肺合并脑卒中患者颈动脉粥样硬化的相关性分析  

Association between inflammatory indexes and carotid atherosclerosis in elderly silicosis patients with stroke

作　　者：邵连双 刘国荣 张文丽 陈伟彬 王大力 李玉梅 李艳丽 Shao Lianshuang;Liu Guorong;Zhang Wenli;Chen Weibin;Wang Dali;Li Yumei;Li Yanli(Department of Occupation Diseases,Kailuan Qianjiaying Hospital,Kailuan 130207,Hebei Province,China)

机构地区：[1]开滦钱家营医院职业病区,130207 [2]华北理工大学附属医院神经内科

出　　处：《中华老年心脑血管病杂志》2021年第3期280-283,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：河北省科技课题(20180748)。

摘　　要：目的探讨同型半胱氨酸(Hcy)、高敏C反应蛋白(hs-CRP)和胱抑制素C(Cys C)与老年矽肺合并脑卒中患者颈动脉粥样硬化的相关性。方法选择开滦钱家营医院和华北理工大学附属医院收治的老年男性矽肺合并脑卒中患者152例作为观察组,患者又根据颈动脉内膜中层厚度(IMT)分为正常组32例(IMT≤1.0 mm);增厚组54例(1.0 mm<IMT<1.3 mm),斑块组66例(IMT≥1.3 mm)。选择同期男性健康查体者90例作为健康组,单纯脑卒中男性患者90例作为对照组。测定各组血清Hcy、hs-CRP和Cys C水平,采用Pearson相关性分析,用多元logistic回归分析颈动脉粥样硬化的危险因素。结果3组血清Hcy、hs-CRP和Cys C水平比较,差异有统计学意义(P=0.001)。观察组Hcy[(14.35±4.51)μmol/L vs(5.27±2.19)μmol/L和(11.65±3.97)μmol/L]、hs-CRP[(6.20±2.38)mg/L vs(2.12±0.64)mg/L和(4.99±2.53)mg/L]和Cys C[(2.27±0.47)mg/L vs(0.72±0.25)mg/L和(1.51±0.58)mg/L]水平均较健康组和对照组明显增高,有统计学差异(P<0.05);斑块组与增厚组和正常组Hcy、hs-CRP和Cys C水平两两比较,均有统计学差异(P<0.05)。增厚组和斑块组Hcy、hs-CRP和Cys C水平与IMT呈正相关(P<0.05,P<0.01)。多元logistic回归分析示,Hcy、hs-CRP和Cys C是颈动脉粥样硬化形成的危险因素(OR=2.615,95%CI:1.492~4.662;OR=3.104,95%CI:1.582~6.998;OR=2.087,95%CI:1.495~4.535,P=0.000)。结论Hcy、hs-CRP和Cys C水平可能可以作为老年矽肺合并脑卒中患者是否发生颈动脉粥样硬化的筛选指标。Objective To study the association of Hcy,hs-CRP and Cys C with carotid atherosclerosis in elderly silicosis patients with stroke.Methods One hundred and fifty-two elderly silicosis patients with stroke served as an observation group.The patients were divided into carotid IMT≤1.0 mm group(n=32),carotid IMT>1.0 mm but<1.3 mm group(n=54)and carotid atherosclerotic plaque group(n=66)with 90 persons undergoing physical examination during the same period served as healthy group and 90 simple stroke patients served as a control group.Their serum levels of Hcy,hs-CRP and Cys C were measured.The risk factors for carotid atherosclerosis were analyzed by multivariate logistic regression analysis.Results The serum levels of Hcy,hs-CRP and Cys C were significantly higher in observation group than in healthy group and control group(14.35±4.51μmol/L vs 5.27±2.19μmol/L and 11.65±3.97μmol/L,6.20±2.38 mg/L vs 2.12±0.64 mg/L and 4.99±2.53 mg/L,2.27±0.47 mg/L vs 0.72±0.25 mg/L and 1.51±0.58 mg/L,P<0.05)and in observation group than in carotid atherosclerotic plaque group,carotid IMT>1.0 mm but<1.3 mm group and carotid IMT≤1.0 mm group(P<0.05).The serum levels of Hcy,hs-CRP and Cys C were positively associated with the carotid IMT in carotid IMT>1.0 mm but<1.3 mm group and carotid atherosclerotic plaque group(P<0.05,P<0.01).Multivariate logistic regression analysis showed that Hcy,hs-CRP and Cys C were the risk factors for carotid atherosclerosis(OR=2.615,95%CI:1.492-4.662;OR=3.104,95%CI:1.582-6.998;OR=2.087,95%CI:1.495-4.535;P=0.000).Conclusion Serum levels of Hcy,hs-CRP and Cys C can be used as an indicator for detecting carotid atherosclerosis in elderly silicosis patients with stroke.

关 键 词：矽肺 卒中 颈动脉疾病 动脉粥样硬化 高半胱氨酸 C反应蛋白质 半胱氨酸蛋白酶抑制物C 

分 类 号：R135.2[医药卫生—劳动卫生] R743.3[医药卫生—公共卫生与预防医学]