缺血性卒中患者血清抗磷脂蛋白抗体浓度与颈动脉粥样硬化的相关性

The relationship between serum level of anticardiolipin antibody and carotid atheroscleros IS in patients with acute cerebral infarction

目的探究缺血性卒中患者血清抗心磷脂抗体浓度与颈动脉粥样硬化斑块及其危险因素的相关性。方法连续纳入310例颈内动脉系统IS患者,应用血管彩色多普勒超声仪进行颈部血管超声检测,根据有无CAS斑块及颈内动脉狭窄程度将患者分为3组:其中A组(无斑块无狭窄)80例;B组(有斑块无狭窄)101例;C组(有斑块有狭窄)129例,C组中1°狭窄42例,2°狭窄36例,3°狭窄33例,4°狭窄18例。采用ELISA检测患者血清ACA浓度,同时检测常规生化指标。结果 A、B、C组患者血清ACA浓度依次为(8.21±7.86)PLU/ml、(13.57±8.04)PLU/ml、(26.54±10.35)PLU/ml;B组、C组患者血清ACA水平明显高于A组(P<0.05),C组患者血清ACA水平明显高于B组(P<0.05);血清ACA水平随CAS狭窄程度的增加而增高。Logistic回归分析显示,血清ACA是否为阳性与TG水平密切相关。结论血清ACA参与动脉粥样硬化的形成、发展,TG是血清ACA阳性的重要危险因素,血清ACA可作为CAS的血清生化指标。

Objective To investigate the relationship between serum levels of anticardiolipin antibody （A CA ） and carotid atherosclerosis （CAS） and its risk factors in patients with acute cerebral infarction （IS）. Methods A total of 310 IS patients of internal carotid artery system were recruited and carotid arteries were measured by vascular doppler ultrasound instrument. According to the presence of carotid atherosclerotic plaque and the degree of carotid stenosis, the patients were divided into three groups ： group A （ no plaque and stenosis） with 80 case s, group B （plaque but having no stenosis） with 101 cases,group C （plaque and stenosis） with 129 cases. Among the 129 patients of group C,case number of 1,2,3 and 4 grade of carotid stenos IS was 42,36,33 and 18 respectively. The serum levels of ACA were measured by ELISA and the routine biochemical indicators were detected at the same time. Results The serum level of ACA in patients of groups A , B ,Cwas （8.21±7.86） PLU/ml, （ 13.57±8.04） PLU/ml, （2 6 .5 4 ± 1 0 .3 5 ） PLU/m lre spe ctive ly .Semmleve lofACA between patients of group B and C was significantly higher than group A （P 〈0. 05） and serum level of ACA was the highest in patients of group C. As carotid atherosclerosis stenosis progressed,serum level of ACA antibody increased. Serum level of ACA antibody was positively associated with Triglyceride （TG）. Conclusion Serum levels of ACA antibody play a role in the occurrence and development of carotid stenosis and TG was the independent risk factor of increased serum levels of ACA. Serum ACA may be used as one of the serum biochemical indexes of carotid artery atherosclerosis.