大动脉粥样硬化性脑梗死患者趋化因子CXCL16水平与微栓子检测的相关性

摘要

目的 探讨大动脉粥样硬化性脑梗死患者急性期血清趋化因子CXCL16(CXCL16)水平及其与微栓子之间的关系.方法 纳入61例颈内动脉或大脑中动脉供血区的动脉粥样硬化性脑梗死急性期的患者,根据微栓子信号(MES)的检测结果,分为MES阳性组(17例)与MES阴性组(44例);对照组74例为同期健康体检人群.应用ELISA法检测所有受试者血清CXCL16的水平,两组之间进行比较.采用多元Logistic相关回归分析显示大动脉粥样硬化性脑梗死患者的危险因素.结果 ①脑梗死患者的血清CXCL16水平(2.3±0.4)μg/L高于对照组(2.0±0.5)μg/L,差异有统计学意义(t=4.258,P＜0.01).②MES阳性组患者的血清CXCL16水平(2.6±0.4)μg/L高于MES阴性组(2.3±0.4)μg/L和对照组,MES阴性组的血清CXCL16水平高于对照组,差异均有统计学意义(P＜0.05).③多元Logistic回归分析显示,CXCL16水平(OR=7.542,95%CI:2.470~23.031)、三酰甘油(OR=4.471,95%CI:1.646~12.145)、高血压(OR=0.295,95%CI:0.120~0.725)是大动脉粥样硬化性脑梗死的独立危险因素.结论 血清CXCL16水平在脑梗死急性期升高,MES阳性组血清CXCL16水平最高.血清CXCL16水平升高是大动脉粥样硬化性脑梗死的独立危险因素.%Objective To investigate the correlation between the acute serum chemokine CXCL16 level and microemboli in patients with large artery atherosclerotic cerebral infarction. Methods A total of 61 patients with acute atherosclerotic cerebral infarction in the internal carotid artery or middle cerebral artery regions were included in the study. According to the results of microembolic signals ( MES ) detection, they were divided into a MES positive group ( n = 17 ) and a MES negative group ( n =44 ). 74 healthy individuals were collected as the control group. The serum CXCL16 levels in all the subjects were assayed using enzyme-linked immunorbent assay ( ELISA ), and they were compared between two groups. The risk factors for large artery atherosclerotic cerebral infarction were revealed using multivariate logistic regression analysis. Results ①The serum CXCL16 level 2. 3 ±0. 4 |Jig/L in the patient groups were significantly higher than 2. 0 ± 0. 5 |Jig/L in the control group. There was significant difference ( t = 4. 258, P < 0. 01 ). ②The serum CXCL16 level 2. 6 ±0. 4 |Jig/L in the MES positive group was higher than 2. 3 ±0. 4 |Jig/L in the MES negative group and the control group. The serum CXCL16 level in the MES negative group was higher than that in the control group. There was significant difference ( P <0. 05 ). ③Multivariate logisticregression analysis showed that the CXCL16 level (OR: 1. 542, 95% CI: 2. 470 - 23.031 ), high triacylg-lyceroK OR: 4.471, 95% CI: 1. 646 - 12. 145 ),and hypertension ( OR: 0.295, 95% CI: 0. 120 -0.725 ) were the independent risk factors for large artery atherosclerotic cerebral infarction. Conclusion The serum CXCL16 level increased in the acute phase of cerebral infarction. The serum CXCL16 level in the MES positive group was the highest. The increased serum CXCL16 level is an independent risk factor for large artery atherosclerotic cerebral infarction.