脑梗死患者血清补体、C反应蛋白水平与颈动脉斑块关系的初步研究

Association of serum complement levels and C-reactive protein level with carotid plaque in patients with cerebral infarction CAO

目的研究脑梗死患者血清补体系统与颈动脉斑块之间的关系。方法对155例脑梗死住院患者通过颈动脉彩色超声确定有无颈动脉斑块，根据斑块的有无分为颈动脉斑块组（n=721和对照N（n=83）。两组之间性别、年龄无显著差异。采用免疫比浊法测定两组血清补体C3、C4水平以及C反应蛋白（CRP）水平，同时调查血糖、血脂、吸烟、酗酒、高血压、糖尿病、卒中家族史等其他危险因素。结果颈动脉斑块组吸烟、酗酒和糖尿病的比例及血清补体C4和CRP水平均显著高于对照组（P〈0．05）。Logistic回归分析提示高血清补体C4水平和高血清CRP水平对于颈动脉斑块的发生有显著影响，比值比（0R）值分别为5．33[95％可信区间（CI）：1．01～28．35]、4．78（95％CI：1．64-13．96）。吸烟和酗酒未能进入回归方程。结论高血清补体C4水平和高CRP水平为颈动脉斑块独立危险因素。

Objective To study the relationship between serum complement system and carotid plaque in the patients with ischemic cerebrovascular diseases. Methods 155 in-patients with cerebral infarction were screened for carotid plaque by duplex color Doppler, and then classified into plaque group （n=72） and control group （n=83）. No statistical difference in age and gender existed between the 2 groups. The serum concentrations of C3, C4 and C-reactive protein （CRP） level were measured by immunoturbidimetry. The other possible risk factors for stroke such as serum lipids and glucose, smoking, drinking, hypertension, diabetes, family history of stroke were investigated. Results Compared with controls, smoking, drinking and diabetes were more firequent in plaque group. The serum levels of C4 and CRP were higher in plaque group than those in controls （P〈0.05）. Logistic regression analysis showed that the odd ratios of high serum levels of C4 and CRP for carotid plaque were 5.33 （95%CI： 1.01-28.35）, 4.78 （95%CI： 1.64-13.96） respectively. Smoking and drinking were excluded from the regression equation. Conclusion High serum levels of C4 and CRP are independent risk factors for carotid plaque.