正五聚蛋白3与缺血性卒中患者颈动脉狭窄的关系研究

doi:10.3969/j.issn.1673-5765.2020.05.011

摘要/Abstract

摘要：

目的通过分析急性缺血性卒中患者血浆正五聚蛋白3（pentraxin 3，PTX3）和凝集素样氧化型低密度脂蛋白受体-1（lectin-like oxidized low density lipoprotein receptor-1，LOX-1）与颈动脉狭窄的关系，探索PTX3在颈动脉狭窄形成过程中的作用。方法前瞻性连续纳入2019年1-8月于首都医科大学附属北京友谊医院神经内科治疗的急性缺血性卒中患者，收集患者的基线资料、头颅CTA、血脂、PTX3、LOX-1等检查结果。根据患者头颅CTA有无颈动脉狭窄分为颈动脉狭窄组和无颈动脉狭窄组；以狭窄程度为标准，将颈动脉狭窄组患者分为严重狭窄（≥50%）组和轻度狭窄（＜50%）组。采用单因素分析和多因素Logistic回归分析颈内动脉狭窄的独立危险因素。结果共纳入102例患者，颈动脉狭窄组57例（55.9%），无颈动脉狭窄组45例（44.1%），颈动脉狭窄组中轻度狭窄32例（56.1%），严重狭窄25例（43.9%）；颈动脉狭窄组的缺血性脑血管病家族史比例、 LDL-C、PTX3及LOX-1水平均高于无颈动脉狭窄组（均P <0.05）；严重狭窄组的PTX3、LOX-1及LDL-C水平均高于轻度狭窄组（均P <0.05）。多因素Logistic回归分析结果显示PTX3（OR 3.11，95%CI 2.11～4.58， P =0.007）、LOX-1（OR 5.47，95%CI 2.89～10.13，P =0.017）和LDL-C（OR 5.35，95%CI 2.45～10.65， P =0.021）水平升高是颈动脉狭窄发生的独立危险因素。结论血浆PTX3、LOX-1和LDL-C水平升高是颈动脉狭窄的独立危险因素。

文章导读： 炎症介质与脂质代谢之间可能存在联系，PTX3、LDL-C和LOX-1水平升高是颈动脉狭窄发生的独立危险因素。

关键词: 正五聚蛋白3; 凝集素样氧化型低密度脂蛋白受体-1; 低密度脂蛋白胆固醇; 颈动脉狭窄; 缺血性卒中

Abstract:

Objective To evaluate the association of plasma pentraxin 3 (PTX3) level and carotid stenosis in patients with acute ischemic stroke (AIS). Methods Consecutive AIS patients who underwent head and neck CTA in Department of Neurology of Beijing Friendship Hospital, Capital Medical University were prospectively enrolled in this study. Baseline data were collected. Based on the CTA results, the patients were divided into carotid stenosis group and no carotid stenosis group. The carotid stenosis group was further divided into severe stenosis subgroup and moderate stenosis subgroup. Univariate and multivariate logistic regression analysis was performed to determine the independent risk factors for carotid stenosis. Results A total of 102 patients were included, with 57 cases (55.9%) in carotid stenosis group and 45 cases (44.1%) in no carotid stenosis group, and 32 cases (56.1%) in moderate stenosis subgroup and 25 cases (43.9%) in severe stenosis subgroup. The percentage of ischemic cerebrovascular disease

history and plasma PTX3, LOX-1, and LDL-C levels were higher in carotid stenosis group than that in no carotid stenosis group (all P <0.05). The level of plasma PTX3, LOX-1 and LDL-C were higher in severe stenosis subgroup than that in moderate stenosis (all P <0.05). The multivariate logistic regression analysis showed that the level of plasma PTX3, LOX-1 and LDL-C were all independent risk factors for carotid stenosis (OR 3.11, 95%CI 2.11-4.58, P =0.007; OR 5.47, 95%CI 2.89-10.13, P =0.017; OR 5.35, 95%CI 2.45-10.65, P =0.021). Conclusions High level of plasma PTX3, LOX-1 and LDL-C were independent risk factors for carotid stenosis.

Key words: PTX3; LOX-1; LDL-C; Carotid stenosis; Ischemic stroke

易立，杨伊姝，张婷婷，陈彬，汤劼. 正五聚蛋白3与缺血性卒中患者颈动脉狭窄的关系研究[J]. 中国卒中杂志, 2020, 15(05): 522-526.

YI Li,YANG Yi-Shu, ZHANG Ting-Ting, CHEN Bin, TANG Jie. Correlation between Plasma PTX3 Level and Carotid Stenosis in Patients with Ischemic Stroke[J]. Chinese Journal of Stroke, 2020, 15(05): 522-526.

参考文献

[1] UCHINO K，RISSER J M，SMITH M A，et al.

Ischemic stroke subtypes among Mexican Americans

and non-Hispanic whites：the BASIC Project[J].

Neurology，2004，63（3）：574-576.

[2] SABA L，MALLARINI G. A comparison between

NASCET and ECST methods in the study of

carotids：evaluation using multi-detector-row CT

angiography[J]. Eur J Radiol，2010，76（1）：42-47.

[3] SHINDO A，MAKI T，MANDEVILLE E T，et

al. Astrocyte-derived Pentraxin 3 supports bloodbrain

barrier integrity under acute phase of stroke[J].

Stroke，2016，47（4）：1094-1100.

[4] SAWAMURA T，WAKABAYASHI I，OKAMURA

T. LOX-1 in atherosclerotic disease[J]. Clin Chim

Acta，2015，440：157-163.

[5] HUANG W S，LI Q，CHEN X L，et al. Soluble

lectin-like oxidized low-density lipoprotein

receptor-1 as a novel biomarker for large-artery

atherosclerotic stoke[J]. Int J Neurosci，2017，127

（10）：881-886.

[6] North American Symptomatic Carotid Endarterectomy

Trial Collaborators，BARNETT H J M，TAYLOR D

W，et al. Beneficial effect of carotid endarterectomy

in symptomatic patients with high-grade carotid

stenosis[J]. N Engl J Med，1991，325（7）：445-453.

[7] MATSUBARA J，SUGIYAMA S，NOZAKI T，et al.

Pentraxin 3 is a new inflammatory marker correlated

with left ventricular diastolic dysfunction and heart

failure with normal ejection fraction[J]. J Am Coll

Cardiol，2011，57（7）：861-869.

[8] 易立，郭芳. 正五聚素蛋白3的功能研究进展[J]. 中国

卒中杂志，2016，11（10）：894-896.

[9] RISTAGNO G，FUMAGALLI F，BOTTAZZI B，et

al. Pentraxin 3 in cardiovascular disease[J]. Front

Immunol，2019，10：823.

[10] 易立，脱厚珍，郭芳，等. 正五聚素蛋白3在氧化型低

密度脂蛋白诱导的平滑肌细胞中的表达[J]. 中华老

年心脑血管病杂志，2017，19（11）：1196-1198.

[11] KARAKAS M F，BUYUKKAYA E，KURT M，et

al. Plasma pentraxin 3 levels are associated with the

complexity and severity of coronary artery disease

in patients with stable angina pectoris[J]. J Investig

Med，2013，61（2）：278-285.

[12] OHBAYASHI H，MIYAZAWA C，MIYAMOTO

K，et al. Pitavastatin improves plasma pentraxin

3 and arterial stiffness in atherosclerotic patients

with hypercholesterolemia[J]. J Atheroscler Thromb，

2009，16（4）：490-500.

[13] ZANETTI M，ZENTI M，BARAZZONI R，et al.

HELP LDL apheresis reduces plasma pentraxin

3 in familial hypercholesterolemia[J/OL]. PLoS

One，2014，9（7）：e101290[2019-11-03]. https：//doi.

org/10.1371/journal.pone.0101290.

[14] WHITE S J，SALA-NEWBY G B，NEWBY A C.

Overexpression of scavenger receptor LOX-1 in

endothelial cells promotes atherogenesis in the

ApoE-/- mouse model[J]. Cardiovasc Pathol，2011，25

（5）：495-500.

[15] TAKANABE-MORI R，ONO K，SOWA N，et

al. Lectin-like oxidized low density lipoprotein

receptor-1 is required for the adipose tissue

expression of proinflammatory cytokines in high-fat

diet-induced obese mice[J]. Biochem Biophys Res

Commun，2010，398（3）：576-580.