血清抵抗素、脂联素、C 反应蛋白水平变化与急性脑梗死患者颈动脉粥样硬化的相关性分析

摘要

目的：探讨血清抵抗素、脂联素、C 反应蛋白（CRP）水平变化与急性脑梗死患者颈动脉粥样硬化的相关性。方法选取2011年11月至2013年7月收治的106例急性脑梗死患者为研究对象。检测患者入院时的血清抵抗素、脂联素及 CRP 水平；所有患者接受彩色多普勒超声检测颈动脉，记录颈动脉内-中膜厚度（IMT）、粥样硬化斑块数等；根据超声结果分为无斑块组、稳定斑块组和不稳定斑块组，同期另选50例体检健康者为对照组，比较各组相关指标的差异。结果不稳定斑块组收缩压（SDP）、舒张压（SBP）高于另外三组（ P ﹤0.05）；不稳定斑块组空腹血糖（FPG）高于另外三组（ P ﹤0.05），血清抵抗素及 CRP 从对照组到不稳定性斑块组逐渐增高（ P ﹤0.05），而血清脂联素则逐渐降低（ P ﹤0.05）；脑梗死病例组中的颈动脉硬化发生率、平均颈动脉斑块数、IMT 高于对照组（ P ﹤0.05）；Pearson 线性相关性分析提示：血清抵抗素与 CRP 呈正相关（ r =0.476，P ﹤0.05），与 IMT 呈正相关（ r =0.398，P ﹤0.05），而与脂联素呈负相关（ r =-0.514，P ﹤0.05）；脂联素与 CRP（ r =-0.367，P ﹤0.05）及 IMT（ r =-0.597，P ﹤0.05）呈负相关。多元逐步回归分析提示：血清抵抗素及 CRP 水平与 IMT 呈正相关（ P ﹤0.05），而脂联素则与其呈负相关（ P ﹤0.05）；多因素非条件 Logistic 回归分析提示：SBP、血清抵抗素及 CRP 是颈动脉不稳定性斑块发生的高危因素，而脂联素则是其保护因素。结论血清抵抗素及 CRP 在急性脑梗死患者中显著升高，而脂联素降低，血清抵抗素及 CRP 与脑梗死颈动脉不稳定性斑块及 IMT 密切相关，而脂联素则可能具有抗炎功能而抑制粥样硬化形成的作用。%Objective To explore the relationship between serum resistin,adiponectin and C - reactive protein(CRP)levels and carotid atherosclerosis in patients with acute cerebral infarction. Methods 106 cases of acute cerebral infarction patients in our hospital from November 2011 to July 2013 were selected as the research subjects. Serum resistin,adiponectin and CRP were detected in patients on admission. All patients received color doppler ultrasonic of carotid artery,and carotid intima - medial thickness(IMT),number of atherosclerotic plaque were recorded. All patients were divided into no plaque group,stable plaque group and unstable plaque group according to the result of ultrasonic. Meanwhile,50 cases of healthy subjects were selected as control group. The differences between the related groups were compared. Results SDP,SBP and FPG of unstable plaque group were higher than those of the other three groups( P ﹤ 0. 05). Serum resistin and CRP levels gradually increased from the control to the unstable plaque group( P ﹤ 0. 05). However,serum adiponectin gradually decreased( P ﹤ 0. 05). Incidence of carotid atheroscle-rosis,average number of carotid plaques and IMT in cerebral infarction cases group,were higher than the control group( P ﹤ 0. 05). Pearson cor-relation analysis showed that serum resistin was positively correlated with CRP( r = 0. 476,P ﹤ 0. 05),and was positively correlated with IMT( r = 0. 398,P ﹤ 0. 05),and negatively correlated with adiponectin( r = - 0. 514,P ﹤ 0. 05). Adiponectin was negatively correlated with CRP ( r = - 0. 367,P ﹤ 0. 05)and IMT( r = - 0. 597,P ﹤ 0. 05). Multiple stepwise regression analysis showed that serum resistin and CRP level were positively correlated with IMT( P ﹤ 0. 05),whereas adiponectin was negatively correlated IMT( P ﹤ 0. 05). Multi - factor unconditioned logistic regression analysis showed that SBP,serum resistin and CRP were risk factors of instability carotid plaque,and adiponectin was the protec-tive factor. Conclusion Serum resistin and CRP levels significantly increased in patients with acute cerebral infarction. The serum adiponectin level decreased;serum resistin and CRP are closely related to instability carotid plaque and IMT,while adiponectin may have anti - inflammatory function to inhibit the formation atherosclerotic plaques.