超敏C反应蛋白水平与脑梗死患者颅内动脉狭窄的相关性分析  

The association of high-sensitivity C-reactive protein with intracranial arterial stenosis of stroke patients

作　　者：李弥弥 刘淑芬 李林益 陈春暖[1] LI Mimi;LIU Shufen;LI Linyi;CHEN Chunnuan(The Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,China)

机构地区：[1]福建医科大学附属第二医院,福建泉州362000

出　　处：《中国实用神经疾病杂志》2023年第5期555-559,共5页Chinese Journal of Practical Nervous Diseases

基　　金：福建省卫生健康科技计划项目青年科研课题(编号:2019-1-54);福建医科大学附属第二医院苗圃课题(编号:2017MP12)。

摘　　要：目的探讨超敏C反应蛋白(Hs-CRP)水平与脑梗死患者颅内动脉狭窄的关系。方法纳入2021-10—2022-12于福建医科大学附属第二医院完成头颅CTA检查的脑梗死病人,年龄均>60岁,NIHSS评分≤3分。根据脑动脉狭窄情况将其分成4组:(1)颅内动脉狭窄(ICAS)组;(2)颅内合并颅外动脉狭窄(IEAS)组;(3)颅外动脉狭窄(ECAS)组;(4)无颅内及颅外动脉狭窄(NOAS)组。运用单因素分析及多元回归分析去探讨颅内动脉狭窄可能的危险因素。ROC曲线计算Hs-CRP对颅内动脉狭窄的预测价值。结果共入组203例,ICAS组73例(35.96%),IEAS组47例(23.15%),ECAS组23例(11.33%),NOAS组60例(29.56%)。与NOAS组相比,Hs-CRP水平ICAS和IEAS组升高(P=0.011,P=0.004),但在ECAS和NOSAS组中没有区别(P=0.080)。多元回归分析结果提示Hs-CRP是颅内动脉狭窄的危险因素(OR1.138,95%CI:1.044~1.240,P=0.003)。经ROC曲线分析,Hs-CRP的AUC值为0.632,最佳截断值为3.96mg/L(95%CI:0.555~0.710,P=0.001),灵敏度和特异度分别为0.500、0.735。结论超敏C反应蛋白水平升高是脑梗死患者颅内动脉硬化性狭窄的独立危险因素。Objective To determine the relationship of high-sensitivity C-reactive protein(Hs-CRP)be⁃tween intracranial atherosclerotic stenosis in people with cerebral infarction.Methods We assessed acute ischemic stroke(NIHSS≤3)patients aged over 60 years in our facility between October 2021 and December 2022 retrospectively.All the participants had a completed computed tomography angiography(CTA).Based on the location of stenosis of cerebral arteries,patients were divided into four groups:intracranial stenosis atherosclerosis(ICAS)group,extracranial atherosclerosis stenosis(ECAS)group,intracranial and extracranial atherosclerotic stenosis(IEAS)group,non-artery stenosis(NOAS)group.The correlation of influencing factors and intracranial atherosclerosis stenosis was assessed by single factor analysis and multiple logistic regression analyses.Results Totally 203 participants were enrolled totally.73(35.96%)were classified as intracranial stenosis atherosclerosis(ICAS)group,47(23.15%)as IEAS,23(11.33%)as ECAS,60(29.56%)as NOAS.Participants in ICAS and IEAS groups tended to have comparative higher levels of Hs-CRP(P=0.011,P=0.004),but the significant difference of Hs-CRP between ECAS and NOAS was not observed(P=0.080).With a multivariable analysis,Hs-CRP concentra⁃tion remained independently related to the groups with intracranial arterial stenosis(OR:1.138,95%CI:1.044—1.240,P=0.003).The ROC analysis revealed that the area under the curve(AUC)of Hs-CRP for detecting intra⁃cranial stenosis was 0.632(95%CI:0.555—0.710,P=0.001)with an optimal cut-of value of 3.96 mg/L,sensitivity and speciality rate were 0.500 and 0.735,respectively.Conclusions Hs-CRP elevation is a predictor of intracra⁃nial atherosclerosis stenosis in patients wiht ischemic stroke.

关 键 词：脑梗死 颅内动脉狭窄 超敏C反应蛋白 炎症 动脉硬化 

分 类 号：R743.33[医药卫生—神经病学与精神病学]