国际脑血管病杂志
國際腦血管病雜誌
국제뇌혈관병잡지
INTERNATIONAL JOURNAL OF CEREBROVASCULAR DISEASES
2013年
10期
759-763
,共5页
李辉%陆海芬%姜亚军%周正国%吴意赟%徐大华%高峰
李輝%陸海芬%薑亞軍%週正國%吳意赟%徐大華%高峰
리휘%륙해분%강아군%주정국%오의빈%서대화%고봉
卒中%脑缺血%颈动脉疾病%动脉粥样硬化%抑半胱氨酸蛋白酶蛋白C%超声检查%生物学标记%危险因素
卒中%腦缺血%頸動脈疾病%動脈粥樣硬化%抑半胱氨痠蛋白酶蛋白C%超聲檢查%生物學標記%危險因素
졸중%뇌결혈%경동맥질병%동맥죽양경화%억반광안산단백매단백C%초성검사%생물학표기%위험인소
Stroke%Brain Ischemia%Carotid Artery Diseases%Atherosclerosis%Cystatin C%Ultrasonography%Biological Markers%Risk Factors
目的 探讨血浆半胱氨酸蛋白酶抑制剂C(cystatin C,CysC)水平与缺血性卒中患者颈动脉粥样硬化斑块的相关性.方法 回顾性分析急性缺血性卒中患者的临床资料,根据颈部血管超声检查结果分为无斑块组和斑块组,再将斑块组分为稳定斑块组和易损斑块组,采用多变量logistic回归分析和Pearson相关分析,探索颈动脉粥样硬化斑块的危险因素.结果 共纳入226例急性缺血性卒中患者,其中172例存在颈动脉斑块,54例无斑块.存在颈动脉斑块的患者中,94例为稳定斑块,78例为易损斑块.斑块组年龄[(71.82 ±9.94)岁对(60.74±13.81)岁；t=6.160,P=0.014]、缺血性心脏病患者比例(11.6％对1.9％；6.169,P=0.020)、收缩压[(148.770± 21.007)mm Hg对(142.240 ± 19.404) mm Hg;t=2.029,P=0.044;1 mm Hg=0.133 kPa]和血浆CysC浓度[(1.046±0.438) mg/L对(0.860±0.214) mg/L;t=3.006,P=0.003]以及颈动脉IMT[(1.122±0.278)mm对(0.878 ±0.250) mm;t =5.762,P=0.000]显著性高于无斑块组.多变量logistic回归分析显示,年龄[优势比(odds ratb,OR)1.079,95％可信区间(confidence interval,CI)1.044 ～1.116;P =0.000]和IMT(OR 31.450,95％ CI 6.233 ～ 158.692;P =0.000)是颈动脉斑块的独立危险因素,而血浆CysC水平与颈动脉斑块无显著独立相关性(P=0.217).稳定斑块组仅IMT显著性高于易损斑块组[(1.176±0.285) mm对(1.058±0.258) mm;t=-2.824,P=0.005],而且IMT(OR0.195,95％ CI0.059～0.064;P =0.007)是颈动脉斑块稳定性的独立保护因素.Pearson相关性分析显示,血浆CysC水平与年龄(r =0.375,P=0.000)和血清肌酐水平(r=0.462,P=0.000)呈正相关,但与颈动脉IMT(r=0.075,P=0.264)无显著相关性.结论 在缺血性卒中患者中,未发现血浆CysC水平与颈动脉粥样斑块、斑块稳定性以及IMT之间存在相关性.
目的 探討血漿半胱氨痠蛋白酶抑製劑C(cystatin C,CysC)水平與缺血性卒中患者頸動脈粥樣硬化斑塊的相關性.方法 迴顧性分析急性缺血性卒中患者的臨床資料,根據頸部血管超聲檢查結果分為無斑塊組和斑塊組,再將斑塊組分為穩定斑塊組和易損斑塊組,採用多變量logistic迴歸分析和Pearson相關分析,探索頸動脈粥樣硬化斑塊的危險因素.結果 共納入226例急性缺血性卒中患者,其中172例存在頸動脈斑塊,54例無斑塊.存在頸動脈斑塊的患者中,94例為穩定斑塊,78例為易損斑塊.斑塊組年齡[(71.82 ±9.94)歲對(60.74±13.81)歲；t=6.160,P=0.014]、缺血性心髒病患者比例(11.6％對1.9％；6.169,P=0.020)、收縮壓[(148.770± 21.007)mm Hg對(142.240 ± 19.404) mm Hg;t=2.029,P=0.044;1 mm Hg=0.133 kPa]和血漿CysC濃度[(1.046±0.438) mg/L對(0.860±0.214) mg/L;t=3.006,P=0.003]以及頸動脈IMT[(1.122±0.278)mm對(0.878 ±0.250) mm;t =5.762,P=0.000]顯著性高于無斑塊組.多變量logistic迴歸分析顯示,年齡[優勢比(odds ratb,OR)1.079,95％可信區間(confidence interval,CI)1.044 ～1.116;P =0.000]和IMT(OR 31.450,95％ CI 6.233 ～ 158.692;P =0.000)是頸動脈斑塊的獨立危險因素,而血漿CysC水平與頸動脈斑塊無顯著獨立相關性(P=0.217).穩定斑塊組僅IMT顯著性高于易損斑塊組[(1.176±0.285) mm對(1.058±0.258) mm;t=-2.824,P=0.005],而且IMT(OR0.195,95％ CI0.059～0.064;P =0.007)是頸動脈斑塊穩定性的獨立保護因素.Pearson相關性分析顯示,血漿CysC水平與年齡(r =0.375,P=0.000)和血清肌酐水平(r=0.462,P=0.000)呈正相關,但與頸動脈IMT(r=0.075,P=0.264)無顯著相關性.結論 在缺血性卒中患者中,未髮現血漿CysC水平與頸動脈粥樣斑塊、斑塊穩定性以及IMT之間存在相關性.
목적 탐토혈장반광안산단백매억제제C(cystatin C,CysC)수평여결혈성졸중환자경동맥죽양경화반괴적상관성.방법 회고성분석급성결혈성졸중환자적림상자료,근거경부혈관초성검사결과분위무반괴조화반괴조,재장반괴조분위은정반괴조화역손반괴조,채용다변량logistic회귀분석화Pearson상관분석,탐색경동맥죽양경화반괴적위험인소.결과 공납입226례급성결혈성졸중환자,기중172례존재경동맥반괴,54례무반괴.존재경동맥반괴적환자중,94례위은정반괴,78례위역손반괴.반괴조년령[(71.82 ±9.94)세대(60.74±13.81)세；t=6.160,P=0.014]、결혈성심장병환자비례(11.6％대1.9％；6.169,P=0.020)、수축압[(148.770± 21.007)mm Hg대(142.240 ± 19.404) mm Hg;t=2.029,P=0.044;1 mm Hg=0.133 kPa]화혈장CysC농도[(1.046±0.438) mg/L대(0.860±0.214) mg/L;t=3.006,P=0.003]이급경동맥IMT[(1.122±0.278)mm대(0.878 ±0.250) mm;t =5.762,P=0.000]현저성고우무반괴조.다변량logistic회귀분석현시,년령[우세비(odds ratb,OR)1.079,95％가신구간(confidence interval,CI)1.044 ～1.116;P =0.000]화IMT(OR 31.450,95％ CI 6.233 ～ 158.692;P =0.000)시경동맥반괴적독립위험인소,이혈장CysC수평여경동맥반괴무현저독립상관성(P=0.217).은정반괴조부IMT현저성고우역손반괴조[(1.176±0.285) mm대(1.058±0.258) mm;t=-2.824,P=0.005],이차IMT(OR0.195,95％ CI0.059～0.064;P =0.007)시경동맥반괴은정성적독립보호인소.Pearson상관성분석현시,혈장CysC수평여년령(r =0.375,P=0.000)화혈청기항수평(r=0.462,P=0.000)정정상관,단여경동맥IMT(r=0.075,P=0.264)무현저상관성.결론 재결혈성졸중환자중,미발현혈장CysC수평여경동맥죽양반괴、반괴은정성이급IMT지간존재상관성.
Objective To investigate the correlation between plasma cystatin C (CysC) level and carotid atherosclerotic plaque in patients with ischemic stroke.Methods The clinical data in patients with acute ischemic stroke were analyzed retrospectively.According to the results of carotid artery ultrasound,the patients were divided into either a non-plaque group or a plaque group.Then the plaque group was redivided into a stable plaque subgroup and a vulnerable plaque subgroup.Multivariate logistic regression analysis and Pearson correlation analysis were used to explore the risk factors for carotid atherosclerotic plaque.Results A total of 226 patients with acute ischemic stroke were enrolled,172 of them had carotid plaque,and 54 had no plaque.Of the patients with carotid plaque,94 were stable plaque and 78 were vulnerable plaque.The age (71.82 ± 9.94 years vs.60.74 ± 13.81 years; t =6.160,P =0.014),proportion of patients with ischemic heart disease (11.6％ vs.1.9％; x2=6.169,P=0.020),systolic blood pressure (148.770± 21.007 mm Hg vs.142.240 ± 19.404 mm Hg; t =2.029,t =0.044),plasma CysC concentration (1.046 ± 0.438 mg/L vs.0.860 ±0.214 mg/L; t =3.006,P =0.003),and carotid IMT (1.122 ±0.278 mm vs.0.878 ±0.250 mm; t =5.762,P=0.000) in the plaque group were significantly higher than those in the non-plaque group.Multivariate logistic regression analysis showed that the age (odds ratio [OR] 1.079,95％ confidence interval [CI] 1.044-1.116; P=0.000) and IMT (OR 31.450,95％ CI 6.233-158.692; P=0.000) was the independent risk factor for carotid plaque,while there was no significant independent correlation between the plasma CysC level and carotid plaque (P =0.217).Only IMT in the stable plaque subgroup was significantly higher than the vulnerable plaque group (1.176 ±0.285 mm vs.1.058 ±0.258 mm; t =-2.824,P =0.005),and it was the independent protective factor for the carotid plaque stability (OR 0.195,95％ CI 0.059-0.064; P =0.007).Pearson correlation analysis showed that the plasma CysC level was positively correlated with the age (r =0.375,P =0.000) and serum creatinine level (r =0.462,P =0.000),but it was not significantly correlated with carotid IMT (r =0.075,P =0.264).Conclusions In patients with ischemic stroke,no correlations were found between the plasma CysC level and carotid atherosclerotic plaque,plaque stability,and IMT.
