血清脂联素及C反应蛋白水平与急性脑梗死患者颈动脉粥样硬化斑块的相关性研究

The correlation of serum adiponectin, C-reactive protein levels and carotid atherosclerosis plaque in patients with acute cerebral infarction

目的探讨血清脂联素（APN）、C反应蛋白（CRP）水平与急性脑梗死（ACI）患者颈动脉粥样硬化斑块的相关性。方法选取ACI患者60例为研究对象（ACI组），均经头颅CT及MRI检查确诊，并选取同期门诊健康体检者60例为对照组，以双抗体夹心酶联免疫吸附试验法检测两组血清APN、CRP水平，超声检查颈动脉粥样硬化情况。结果ACI组治疗前血清APN及CRP水平分别为（4．36±2．54）、（8．93±2．89）mg／L，对照组分别为（8．43±3．51）、（1．12±0．52）mg／L，ACI组血清APN水平显著低于对照组，血清CRP水平显著高于对照组，差异有统计学意义（P〈0．05）；ACI组治疗后血清APN水平较治疗前显著升高，血清CRP水平显著下降，分别为（6．44±2．31）、（4．10±0．72）mg／L，治疗前后比较差异有统计学意义（P〈0．05）。ACI组颈动脉粥样硬化发生率为78．33％（47／60），颈动脉粥样硬化斑块发生率为71．67％（43／60），其中稳定斑块13例，不稳定斑块30例；对照组颈动脉粥样硬化发生率为26．67％（16／60），颈动脉粥样硬化斑块发生率为13．33％（8／60），其中稳定斑块6例，不稳定斑块2例，两组比较差异有统计学意义（P〈0．05）。ACI组无颈动脉粥样硬化斑块者血清APN及CRP水平分别为（6．89±2．37）、（5．41±1．38）mg／L，有颈动脉粥样硬化斑块者分别为（3．28±1．99）、（9．42±3．70）mg／L，颈动脉粥样硬化斑块的有无与血清APN水平呈负相关（r=-0．76，P〈0．05），与血清CRP水平呈正相关（r=0．81，P〈0．05）。稳定斑块者血清APN及CRP水平分别为（4．32±2．14）、（6．65±2．69）ms／L，不稳定斑块者分别为（2．11±1．35）、（10．11±3．82）ms／L，颈动脉粥样硬化斑块稳定程度与血清APN水平呈负相关（r=-0．69，P〈0．05），与血清CRP水平呈正相关（r=0．77，P〈0．05）。结论ACI的发生与颈动脉粥样硬化斑块密切相关，ACI患者较正常人群血清APN水平明显下降，而血清CRP水平明显升高；颈动脉粥样硬化斑块发生率明显升高，且主要为不稳定斑块；颈动脉粥样硬化斑块的有无与血清APN水平呈负相关，与血清CRP水平呈正相关；颈动脉粥样硬化斑块稳定程度与血清APN水平呈负相关，与血清CRP水平呈正相关。

Objective To investigate the correlation of serum adiponectin （APN）,C-reactive protein （CRP） levels and carotid atherosclerosis plaque in patients with acute cerebral infarction （ACI）. Methods Sixty patients with ACI （ACI group） were diagnosed by head CT and MRI examination. And sixty cases of healthy check-up were as control group. The serum APN and CRP were examined by double antibody sandwich enzyme linked immunosorbent assay method,and carotid atherosclerosis was examined by ultrasound. Results The serum APN and CRP levels in ACI group were （4.36 ±2.54）, （8.93 ±2.89） rag/L, and in control group were （8.43 ± 3.51 ）, （ 1.12 ± 0.52） mg/L. The serum APN level in ACI group was significantly lower than that in control group, and the serum CRP level in ACI group was significantly higher than that in control group （P 〈 0.05 ）. In ACI group, the serum APN level after treatment was significantly increased compared with that before treatment,the serum CRP level after treatment was significantly decreased compared with that before treatment. The differences were （6.44 ± 2.31 ） and （4.10 ± 0.72） mg/L respectively. The rate of carotid atherosclerosis in ACI group was 78.33%（47/60）,and the rate of carotid atherosclerosis plaque was 71.67%（43/60）. The stable plaque was in 13 cases and instability plaque was in 30 cases. The rate of carotid atherosclerosis in control group was 26.67%（16/60）,and the rate of carotid atherosclerosis plaque was 13.33%（8/60）. The stable plaque was in 6 cases and instability plaque was in 2 cases. The differences between the two groups had statistical significance （P 〈 0.05 ）. In ACI group, the serum APN and CRP levels in ACI without carotid atherosclerosis plaque were （6.89 ± 2.37） and （5.41 ± 1.38） mg/L,in ACI with carotid atherosclerosis plaque were （3.28 ± 1.99） and （9.42 ± 3.70） mg/L. Carotid atheroselerosis plaque and serum APN level showed negative correlation （r =-0.76,P 〈 0.05 ）, and serum CRP level was positively correlated （r = 0.81 ,P〈 0.05）. The serum APN and CRP levels in ACI with stable plaque were （4.32 ± 2.14） and （6.65 ± 2.69） mg/L,in ACI with instability plaque were （2.11 ± 1.35） and （ 10.11 ± 3.82 ） mg/L. Carotid artery plaque stability and serum APN level showed negative correlation （r = -0.69,P〈0.05）,and serum CRP level was positively correlated （r =0.77,P〈0.05）. Conclusions The occurrence of ACI is closely related to carotid atheroselerotic plaque. The serum APN level in ACI patients is significantly lower than that in normal crowd ,but serum CRP level in ACI patients is significantly higher than that in normal crowd. The rate of carotid atherosclerosis is significantly increased, most of which is instability plaque. Carotid atherosclerosis plaque and serum APN level has negative correlation, and serum CRP level is positively correlated. Carotid artery plaque stability and serum APN level has negative correlation, and serum CRP level is positively correlated.