急性脑梗死患者血清25-羟维生素D3水平与颈动脉斑块易损性的相关性分析

Analysis of correlation between serum 25-hydroxyvitamin D3 level and carotid plaque vulnerability in patients with acute cerebral infarction

目的分析急性脑梗死患者血清25-羟维生素D3[25(OH)D3]水平与颈动脉斑块易损性的相关性。方法选取2017年8月~2018年12月我院收治的140例急性脑梗死(ACI)患者作为研究对象,按照颈动脉黑血磁共振成像(BB-MRI)检查,测定颈动脉血管斑块的稳定性及易损性。按BB-MRI分析斑块特点,分为无斑块组(24例)、稳定斑块组(60例)和易损斑块组(56例)。三组患者均抽取静脉血检测血清中的C反应蛋白(CRP)、胱抑素C(CysC)、尿酸(UA)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、同型半胱氨酸(Hcy)、糖化血红蛋白(HbA1c)、25(OH)D3水平,采用单因素和多因素分析ACI患者血清25(OH)D3水平与颈动脉斑块易损性的相关性。结果三组患者的CysC、UA、TC、TG、HDL-C、LDL-C水平比较,差异无统计学意义(P>0.05);易损斑块组的CRP、FPG、HbA1c和Hcy水平高于稳定斑块组和无斑块组,差异均有统计学意义(P<0.05);稳定斑块组的CRP、FPG、HbA1c和Hcy水平高于无斑块组,差异均有统计学意义(P<0.05)。易损斑块组的25(OH)D3水平低于稳定斑块组和无斑块组,差异均有统计学意义(P<0.05);稳定斑块组的25(OH)D3水平低于无斑块组,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,低水平血清25(OH)D3是急性脑梗死患者颈动脉斑块易损性的保护因素(P<0.05)。结论ACI患者颈动脉易损斑块的形成与低水平血清25(OH)D3独立相关,血清25(OH)D3水平可作为ACI患者临床初筛易损斑块的血清生物学标志物。

Objective To analyze the correlation between serum 25-hydroxyvitamin D3 [25(OH)D3] level and carotid plaque vulnerability in patients with acute cerebral infarction. Methods A total of 140 patients with acute cerebral infarction (ACI) admitted to our hospital from August 2017 to December 2018 were selected as the study subjects, the stability and vulnerability of carotid artery plaques were measured by magnetic resonance imaging (BB-MRI). According to BB-MRI analysis of plaque characteristics, the patients were divided into non-plaque group (24 cases), stable plaque group (60 cases) and vulnerable plaque group (56 cases). The serum C-reactive protein (CRP), cystatin C (CysC), uric acid (UA), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (FPG), homocysteine (Hcy), glycosylated hemoglobin (HbA1c), and 25(OH)D3 levels were measured in all three groups, the correlation between serum 25(OH)D3 level and carotid plaque vulnerability in ACI patients were analyzed by univariate and multivariate analysis. Results There were no significant differences in the levels of CysC, UA, TC, TG, HDL-C and LDL-C among the three groups (P>0.05). The levels of CRP, FPG, HbA1c and Hcy in vulnerable plaque group were higher than those in stable plaque group and non-plaque group, the differences were statistically significant (P<0.05). The levels of CRP, FPG, HbA1c and Hcy in stable plaque group were higher than those in non-plaque group, the differences were statistically significant (P<0.05). The level of 25(OH)D3 in vulnerable plaque group was lower than that in stable plaque group and non-plaque group, the differences were statistically significant (P<0.05). The level of 25(OH)D3 in stable plaque group was lower than that in non-plaque group, the difference was statistically significant (P<0.05). Logistic regression analysis showed that low serum 25(OH)D3 was a protective factor for carotid plaque vulnerability in patients with acute cerebral infarction (P<0.05). Conclusion The formation of carotid vulnerable plaque in ACI patients is independently correlated with low serum 25(OH)D3. Serum 25(OH)D3 level can be used as a serum biological marker for screening vulnerable plaque in ACI patients.