2020 年第 12 期 第 15 卷

急性脑梗死患者血清补体C1q/肿瘤坏死因子相关蛋白3和白细胞介素6水平与颈总动脉内膜中层厚度的关系

The relation among serum C1q/tumor necrosis factor related protein 3, interleukin-6 and carotid intima-media thickness in patients with acute cerebral infarction 

作者：闫振文1郑眉光2李梅1

英文作者：Yan Zhenwen1 Zheng Meiguang2 Li Mei1

单位：1中山大学孙逸仙纪念医院神经内科，广州510120；2中山大学孙逸仙纪念医院神经外科，广州510120

英文单位：1Department of Neurology Sun Yat-Sen Memorial Hospital Sun Yat-Sen University Guangzhou 510120 China； 2Department of Neurosurgery Sun Yat-Sen Memorial Hospital Sun Yat-sen University Guangzhou 510120 China

关键词：急性脑梗死；补体C1q/肿瘤坏死因子相关蛋白3；白细胞介素6；颈总动脉内膜中层厚度

英文关键词：Acutecerebralinfarction;ComplementC1q/tumornecrosisfactorrelatedprotein-3;Interleukin-6;Carotidintimamediathickness

• 摘要：

• 目的 探讨急性脑梗死患者血清补体C1q/肿瘤坏死因子相关蛋白3（CTRP3）、白细胞介素6（IL-6）水平与颈总动脉内膜中层厚度（IMT）的关系。方法 选取2017年1月至2019年6月中山大学孙逸仙纪念医院收治的200例急性脑梗死患者为观察组，另选取同期于本院门诊体检的200例健康志愿者为对照组，比较2组血清CTRP3和IL-6水平、颈总动脉IMT和内径。根据美国国立卫生研究院卒中量表评分将观察组分为轻度损伤组（62例）、中度损伤组（92例）、重度损伤组（46例）。根据IMT值将急性脑梗死患者分为正常组（24例）、增厚组（73例）、斑块形成组（103例）。比较神经缺损程度、动脉硬化程度不同患者血清CTRP3和IL-6水平。采用Pearson双变量相关性分析方法分析血清CTRP3、IL-6水平与颈总动脉IMT之间的关系。结果 观察组患者血清CTRP3水平、颈总动脉内径低于/小于对照组［（87±14）μg/L比（137±36）μg/L、（4.0±0.4）mm比（5.7±0.6）mm］，血清IL-6水平、颈总动脉IMT高于/大于对照组［（116±30）ng/L比（23±7）ng/L、（1.39±0.55）mm比（0.89±0.26）mm］，差异均有统计学意义（均P＜0.05）。中、重度损伤组血清CTRP3水平、颈总动脉内径低于/小于轻度损伤组，且重度损伤组低于/小于中度损伤组，差异均有统计学意义（均P＜0.05）；中、重度损伤组血清IL-6水平、颈总动脉IMT高于/大于轻度损伤组，且重度损伤组高于/大于中度损伤组，差异均有统计学意义（均P＜0.05）。增厚组、斑块形成组血清CTRP3水平低于正常组，且斑块形成组低于增厚组，差异均有统计学意义（均P＜0.05）；增厚组、斑块形成组血清IL-6水平高于正常组，且斑块形成组高于增厚组，差异均有统计学意义（均P＜0.05）。Pearson相关性分析结果显示，急性脑梗死患者血清CTRP3水平与颈总动脉IMT呈负相关（r=-0.565，P=0.012），血清IL-6水平与颈总动脉IMT呈正相关（r=0.671，P=0.009），血清CTRP3水平与IL-6水平呈负相关（r=-0.463，P=0.017）。结论 急性脑梗死患者血清CTRP3水平降低，IL-6水平升高，血清CTRP3、IL-6水平均与颈总动脉IMT密切相关，可能通过影响颈总动脉IMT参与急性脑梗死的发生进展。

• Objective To investigate the relationship among serum C1q/tumor necrosis factor related to protein 3(CTRP3), interleukin-6(IL-6) and common carotid artery intima-media thickness(IMT) in patients with acute cerebral infarction. Methods Totally 200 patients with acute cerebral infarction admitted to Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University from January 2017 to June 2019 were selected as the observation group and 200 healthy volunteers examined in the outpatient clinic of our hospital during the same period were as the control group. The levels of serum CTRP3, IL-6, IMT and diameter of common carotid artery were compared between the two groups. According to the national institute of health stroke scale（NIHSS） score, the observation group was divided into mild injury group(n=62), moderate injury group(n=92) and severe injury group(n=46). According to IMT, patients with acute cerebral infarction were divided into normal group(n=24), thickening group (n=73) and plaque formation group(n=103). The levels of serum CTRP3 and IL-6 in patients with different degrees of nerve defect atherosclerosis were compared. Pearson bivariate correlation was used to analyze the serum CTRP3, IL-6 and common carotid artery IMT. Results The levels of serum CTRP3 and the diameter of common carotid artery in observation group were lower/less than those in control group ［（87±14）μg/L vs （137±36）μg/L, （4.0±0.4）mm vs （5.7±0.6）mm， both P＜0.05］; the levels of serum IL-6 and the IMT of common carotid artery in observation group were higher/more than those in the control group ［（116±30）ng/L vs （23±7）ng/L, （1.39±0.55）mm vs （0.89±0.26）mm， both P＜0.05］. The levels of serum CTRP3 and the diameter of common carotid artery in moderate and severe injury group were lower than those in mild injury group; those in severe injury group were lower than those in moderate injury group (all P＜0.05). The levels of IL-6 and IMT of common carotid artery in moderate and severe injury group were higher than those in mild injury group; those in severe injury group were higher than those in moderate injury group (all P＜0.05). The levels of serum CTRP3 in thickening group and plaque formation group were lower than that in normal group; it was lower in plaque formation group than that in thickening group (all P＜0.05), but the level of IL-6 was higher than that in normal group; it was higher in plaque formation group than that in thickening group (all P＜0.05). Pearson bivariate correlation analysis showed that serum CTRP3 level was negatively correlated with common carotid artery IMT(r=-0.565, P=0.012), serum IL-6 level was positively correlated with common carotid artery IMT(r=0.671, P=0.009) and serum CTRP3 level was negatively correlated with IL-6 level(r=-0.463, P=0.017). Conclusion CTRP3 decreases in patients with acute cerebral infarction; serum CTRP3 and IL-6 are closely related to common carotid artery IMT, which may be involved in the development of acute cerebral infarction.