内正五聚蛋白3和血小板与淋巴细胞比值对急性脑梗死患者颈动脉粥样硬化斑块稳定性和近期预后的影响研究

Impact of PTX3 and PLR on Stability of Carotid Atherosclerostic Plaques and Short-term Prognosis in Patients with Acute Cerebral Infarction

目的探讨内正五聚蛋白3(PTX3)和血小板与淋巴细胞比值(PLR)对急性脑梗死(ACI)患者颈动脉粥样硬化斑块稳定性和近期预后的影响。方法选取2015年1月—2017年6月徐州市中心医院诊治的ACI患者136例,根据颈动脉粥样硬化斑块稳定性分为斑块不稳定组(n=82)和斑块稳定组(n=54),根据治疗后2个月预后分为预后良好组(n=80)和预后不良组(n=56)。比较斑块不稳定组和斑块稳定组患者一般资料、实验室检查指标,PTX3和PLR与ACI患者颈动脉粥样硬化斑块稳定性的关系分析采用非条件多因素Logistic回归分析;比较预后良好组和预后不良组患者PTX3和PLR。结果 (1)斑块不稳定组和斑块稳定组患者性别、年龄、冠心病病史、高血压病史、饮酒史、吸烟史、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、纤维蛋白原(FIB)比较,差异无统计学意义(P>0.05);斑块稳定组患者有糖尿病病史者所占比例、PTX3、PLR低于斑块不稳定组(P<0.05)。(2)非条件多因素Logistic回归分析结果显示,PTX3[OR=1.524,95%CI(1.301,1.784)]、PLR[OR=1.033,95%CI(1.020,1.045)]是ACI患者颈动脉粥样硬化斑块稳定性的独立影响因素(P<0.05)。(3)预后良好组患者PTX3和PLR低于预后不良组(P<0.05)。结论 PTX3和PLR是ACI患者颈动脉粥样硬化斑块稳定性的影响因素,且PTX3和PLR升高者近期预后较差,应引起临床重视。

Objective To investigate the impact of PTX3 and PLR on stability of carotid atherosclerostic plaques and short-termprognosis in patients with acute cerebral infarction.Methods A total of 136 patients with acute cerebral infarction were selected in Xuzhou Central Hospital from January 2015 to June 2017,and they were divided into A1 group(with unstable plaques,n=82)and A2 group(with stable plaques,n=54)according to the stability of carotid atherosclerostic plaques,into B1 group(with good prognosis,n=80)and B2 group(with poor prognosis,n=56)according to the prognosis 2 months after treatment.General information and laboratory examination results were compared between A1 group and A2 group,and non-condition multivariate Logistic regression analysis was used to analyze the relationship between PTX3,PLR and stability of carotid atherosclerostic plaques in patients with acute cerebral infarction;PTX3 and PLR were compared between B1 group and B2 group.Results (1)No statistically significantly differences of gender,age,medical history of coronary artery disease or hypertension,drinking history,smoking history,TG,TC,LDL-C,HDL-C,FIB were found between the two groups between A1 group and A2 group(P>0.05);Proportion of diabetes history,PTX3 and PLR in A2 group were statistically significantly lower than those in A1 group(P<0.05).(2)Non-condition multivariate Logistic regression analysis results showed that,PTX3〔OR=1.524,95%CI(1.301,1.784)〕and PLR〔OR=1.033,95%CI(1.020,1.045)〕were independent influencing factors of stability of carotid atherosclerostic plaques in patients with acute cerebral infarction(P<0.05).(3)PTX3 and PLR in B1 group were statistically significantly lower than those in B2 group(P<0.05).Conclusion PTX3 and PLR are independent influencing factors of stability of carotid atherosclerostic plaques in patients with acute cerebral infarction,elevation of PTX3 and PLR may result in poor stability of carotid atherosclerostic plaques and poor prognosis,which should pay more attentions to on clinic.