血清炎性标志物与急性缺血性卒中患者颈动脉斑块及其稳定性的相关性  

Correlation between serum inflammatory markers and carotid plaque and its stability in patients with acute ischemic stroke

作　　者：许光银 程广杰 李效寅 Xu Guangyin;Cheng Guangjie;Li Xiaoyin(Department of Clinical Laboratory,Liaocheng Third People’s Hospital,Liaocheng Key Laboratory of Diagnosis and Treatment of Cardiocerebrovascular Diseases,Liaocheng 252000,China;Department of Ultrasound,Liaocheng Third People’s Hospital,Liaocheng 252000,China)

机构地区：[1]聊城市第三人民医院检验科,聊城市心脑血管病诊治重点实验室,252000 [2]聊城市第三人民医院超声科,252000

出　　处：《国际脑血管病杂志》2023年第1期23-28,共6页International Journal of Cerebrovascular Diseases

基　　金：山东省医药卫生科技发展计划项目(202011001446)。

摘　　要：目的探讨血清炎性标志物与急性缺血性卒中(acute ischemic stroke,AIS)患者颈动脉斑块及其稳定性的相关性。方法前瞻性纳入2021年6月至2022年4月聊城市第三人民医院收治的AIS患者。收集人口统计学及相关临床资料,采用彩色多普勒超声检测颈动脉斑块,根据斑块特征将患者分为不稳定斑块组、稳定斑块组和无斑块组。检测血清超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、血清淀粉样蛋白A(serum amyloid A,SAA)、白细胞介素(interleukin,IL)-6水平并进行比较。采用多变量logistic回归分析确定颈动脉斑块及稳定性的独立危险因素。结果共纳入201例AIS患者,无斑块组87例(43.30%),稳定斑块组57例(28.35%),不稳定斑块组57例(28.35%)。不稳定斑块组高血压和既往卒中史的患者构成比以及hs-CRP、SAA和IL-6水平显著高于稳定斑块组和无斑块组(P均<0.026)。多变量logistic回归分析显示,在校正其他混杂因素后,IL-6水平增高[优势比(odds ratio,OR)1.174,95%置信区间(confidence interval,CI)1.049~1.314;P=0.005]是存在稳定斑块的独立危险因素,而既往卒中史(OR 3.172,95%CI 1.123~8.957;P=0.029)和IL-6水平增高(OR 1.367,95%CI 1.107~1.687;P=0.004)是存在不稳定斑块的独立危险因素。结论 AIS患者血清IL-6水平明显升高,与颈动脉斑块形成和稳定性密切相关。Objective To investigate the correlation between serum inflammatory markers and carotid plaque and its stability in patients with acute ischemic stroke(AIS).Methods Patients with AIS admitted to Liaocheng Third People’s Hospital from June 2021 to April 2022 were prospectively enrolled.The demographic and relevant clinical data were collected.Color Doppler ultrasound was used to detect carotid artery plaques.The patients were divided into unstable plaque group,stable plaque group and non-plaque group according to plaque characteristics.The levels of serum hypersensitive C-reactive protein(hs-CRP),serum amyloid A(SAA)and interleukin(IL)-6 were detected and compared.Multivariate logistic regression analysis was used to determine the independent risk factors for carotid plaque and its stability.Results A total of 201 patients with AIS were enrolled,including 87 patients(43.30%)in the non-plaque group,57(28.35%)in the stable plaque group,and 57(28.35%)in the unstable plaque group.The proportion of patients with hypertension and previous stroke history,and hs-CRP,SAA and IL-6 levels in the unstable plaque group was significantly higher than those in the stable plaque group and the non-plaque group(all P<0.05).Multivariate logistic regression analysis showed that after adjusting for other confounding factors,the increased IL-6 level(odds ratio[OR]1.174,95%confidence interval[CI]1.049-1.314;P=0.005)was an independent risk factor for the existence of stable plaques,while the previous stroke history(OR 3.172,95%CI 1.123-8.957;P=0.029)and the increased IL-6 level(OR 1.367,95%CI 1.107-1.687;P=0.004)were the independent risk factors for the existence of unstable plaques.Conclusion The serum IL-6 level in patients with AIS increase significantly,which is closely associated with the formation and stability of carotid plaques.

关 键 词：缺血性卒中 颈动脉疾病 斑块 动脉粥样硬化 超声检查 炎症 生物标志物 

分 类 号：R743.3[医药卫生—神经病学与精神病学]