血清CXCR4水平与颅内动脉粥样硬化性狭窄的相关性研究

Association between serum CXCR4 and intracranial atherosclerotic stenosis

目的探讨血清中C-X-C基序趋化因子受体4(C-X-C motif chemokine receptor 4,CXCR4)水平与颅内动脉粥样硬化性狭窄(intracranial atherosclerotic stenosis,ICAS)的关系。方法该研究为病例对照研究。连续性纳入自2022年3月至2023年4月于北京医院神经内科住院治疗的缺血性脑血管病患者。应用颅内动脉检查(MRA、CTA或DSA)评估患者颅内动脉粥样硬化情况,将患者分为ICAS组(颅内动脉狭窄≥50%)和对照组(颅内动脉狭窄<50%),检测两组患者的血清CXCR4水平,通过多因素分析探讨CXCR4水平与ICAS的相关性。根据颅内动脉狭窄程度将ICAS组患者进一步分为中度狭窄组(50%≤颅内动脉狭窄<70%)及重度狭窄组(70%≤颅内动脉狭窄≤100%),比较各组间CXCR4水平的差异。结果共纳入患者264例,其中ICAS组173例〔男125例;年龄(69.05±11.06)岁〕,对照组91例〔男56例;年龄(66.96±11.12)岁〕。ICAS组CXCR4水平高于对照组〔(320.00±46.90)ng/L比(304.00±51.54)ng/L,t=2.472,P=0.014〕。校正相关混杂因素后,Logistic回归分析结果提示CXCR4水平升高〔OR(95%CI):1.007(1.002~1.013),P=0.011〕是ICAS的独立影响因素。ICAS中、重度狭窄组及对照组间CXCR4水平差异有统计学意义(F=5.527,P=0.004),且ICAS重度狭窄组患者血清中CXCR4水平明显高于对照组〔(324.82±45.87)ng/L比(304.00±51.54)ng/L,t=3.132,P=0.002〕及ICAS中度狭窄组〔(324.82±45.87)ng/L比(307.47±47.72)ng/L,t=2.118,P=0.035〕。结论血清CXCR4水平在ICAS患者中升高是ICAS的独立影响因素,有作为评估ICAS潜在生物标志物的潜力。

Objective To investigate the association between serum C-X-C motif chemokine receptor 4(CXCR4)and intracranial atherosclerotic stenosis(ICAS).Methods Patients with ischemic cerebrovascular disease admitted to the Department of Neurology of Beijing Hospital from March 2022 to April 2023 were consecutively enrolled.According to the degree of intracranial stenosis using MR or CT angiography or digital subtraction angiography,the patients were divided into ICAS group(≥50%intracranial stenosis)and control group(<50%intracranial stenosis).The level of serum CXCR4 was detected and logistic regression was used to identify the association between CXCR4 and ICAS.The ICAS group were further divided into the moderate group(50%≤intracranial stenosis<70%)and severe group(70%≤intracranial stenosis≤100%),ANOVA and LSD methods were used for multi-group comparison.Results A total of 264 eligible patients were included in this study,173 patients were in the ICAS group[125 males;mean age(69.05±11.06)years]and 91 patients were in the control group[56 males;mean age(66.96±11.12)years].Compared with the control group,the CXCR4 level was higher in the ICAS group[(320.00±46.90)ng/L vs.(304.00±51.54)ng/L,t=2.472,P=0.014].After adjusting confounding factors,logistic regression analysis showed that serum CXCR4 level was independently associated with ICAS(OR=1.007,95%CI:1.002-1.013,P=0.011).Further more,analysis of variance showed that there were differences in the levels of CXCR4 among control group,moderate group and severe group(F=5.527,P=0.004).The severe group show higher CXCR4 level than that in the control group[(324.82±45.87)ng/L vs.(304.00±51.54)ng/L,t=3.132,P=0.002]and moderate group[(324.82±45.87)ng/L vs.(307.47±47.72)ng/L,t=2.118,P=0.035]by post hoc test,respectively.Conclusions The level of serum CXCR4 was increased in the ICAS patients,which was independently associated with ICAS.CXCR4 might be served as a potential biomarker for ICAS.