缺血性脑卒中患者血清内脂素和髓过氧化物酶水平与颈动脉粥样硬化关系的研究

Relationship of serum visfatin and myeloperoxidase levels and carotid atherosclerosis in patients with ischemic stroke

目的探讨缺血性脑卒中患者血清内脂素(visfatin)、髓过氧化物酶(myeloperoxidase,MPO)水平与颈动脉粥样硬化斑块形成及稳定性之间的关系。方法选取2015年3月-2016年6月常德桃源县人民医院神经内科收治入院的缺血型脑卒中患者139例作为研究对象,另选取本院体检正常者65例作为对照组,采用酶联免疫吸附法检测血清visfatin和MPO水平。收集各入选病例相关临床资料及颈动脉超声检查结果,并计算反映颈动脉斑块的Crouse积分。结果缺血性脑卒中患者血清visfatin、MPO水平均明显高于对照组(P<0.01),且不稳定斑块组血清visfatin、MPO水平以及Crouse积分明显高于稳定斑块组和无斑块组(P<0.01);患者血清visfatin、MPO水平与颈动脉粥样斑块Crouse积分呈正相关(r=0.796,P<0.01;r=0.723,P<0.01);多因素分析结果显示,血清visfatin(OR=1.42,95%CI:1.15~1.75,P=0.001 1)、MPO(OR=1.08,95%CI:1.03~1.13,P=0.001 5)、脂蛋白(a)(OR=1.11,95%CI:1.02~1.21,P=0.015 6)、低密度脂蛋白(OR=2.13,95%CI:1.25~3.63,P=0.005 4)、高血压病(OR=1.98,95%CI:1.13~3.45,P=0.020 1)、糖尿病(OR=1.23,95%CI:1.02~1.48,P=0.030 2)和年龄(OR=1.95,95%CI:1.11~3.43,P=0.020 2)是影响颈动脉粥样硬化患者斑块稳定性的独立危险因素。结论缺血性脑卒中患者血清visfatin、MPO水平与其颈动脉内膜斑块形成及斑块稳定性密切相关,检测患者血清visfatin、MPO水平对缺血性脑卒中的预防、病情监测和治疗有重要临床意义。

Objective To explore the correlation between serum visfatin and myeloperoxidase levels and the formation and stability of carotid atherosclerosis plaques in patients with ischemic stroke. Methods One hundred and thirty-nine ischemic stroke patients hospitalized in Department of Neurology, the Pepole’s Hospital of Taoyuan County, Changde City from March 2015 to June 2016 were selected as the research objects; meanwhile, 65 individuals with healthy check-up Results reported by the hospital served as the controls. Their serum levels of visfatin and myeloperoxidase were determined by enzyme-linked immunosorbent assay. We collected their clinical data and results of carotid ultrasound scan, and then calculated Crouse integral of carotid plaques. Results The serum levels of visfatin and myeloperoxidase were significantly higher in patients with ischemic stroke than in the controls （P〈0.01）; moreover, the serum visfatin and myeloperoxidase levels and Crouse integral were significantly higher in the plaque destabilization group than in the stable plaque group as well as the non-plaque group （all P〈0.01）. The serum levels of visfatin and myeloperoxidase in patients with ischemic stroke were positively correlated with the Crouse integral of carotid plaques（r=0.796, P〈0.01; r=0.723, P〈0.01）. Multivariate linear regression analysis showed that the serum levels of visfatin（OR=1.42,95%CI：1.15-1.75,P= 0.0011）, MPO（OR=1.08 ,95%CI：1.03-1.13 ,P=0.0015 ）, LP（a） （OR=1.11,95%CI：1.02-1.21,P=0.0156）, LDL-C（OR=2.13,95%CI：1.25-3.63,P=0.0054）, hypertension（OR=1.98,95%CI：1.13-3.45,P=0.0201）, diabetes（OR=1.23,95%CI：1.02-1.48,P=0.0302） and age（OR=1.95,95%CI：1.11-3.43, P=0.0202） were the independent risk factors affecting plaque stability of patients with ischemic stroke. Conclusions The serum levels of visfatin and myeloperoxidase in patients with ischemic stroke are closely correlated with the formation and stability of carotid artery intimal plaque; and hence, it is of an important clinical significance to prevention, monitoring and treatment of ischemic stroke with detecting the serum levels of visfatin and myeloperoxidase.