摘要
目的探讨基线血清高敏C反应蛋白（hscRP）水平与颈动脉斑块检出率的关系。方法采用前瞻性队列研究的方法，随机分层抽取唐山开滦（集团）有限责任公司在职及离退休职工中年龄≥40岁、既往无缺血性脑卒中、短暂性脑缺血发作（不包括腔隙性脑梗死）、心肌梗死病史的5852名职工为研究对象，进行统一问卷调查、血液生化及颈动脉超声检查。依据2006-2007年度hsCRP测量值将研究对象分为hsCRP〈1、1～3、〉3～10mg／L组，采用多因素Logistic回归分析2006年hsCRP水平与2010年颈动脉斑块检出率的关系。结果与hsCRP〈1mg／L组相比，hsCRP1～3、〉3～10mg／L组颈动脉斑块检出率（42．6％、50．4％比35．4％）、不稳定斑块检出率（24．0％、28．9％比17．0％）和颈动脉硬化斑块总负荷评分（TBS）[（3．05±1．86）、（3．48±1．82）比（2．65±1．76）]升高（均P〈0．05）；按性别分组后，男性和女性hsCRP1～3、〉3～10mg／L组TBS均较hsCRP〈1mg／L组升高[男性（3．60±1．85）、（3．88±1．86）比（3．16±1．66）；女性（2．34±1．62）、（2．97±1．63）比（1．90±1．63）；均P〈0．05]。影响颈动脉斑块及不稳定斑块的多因素Logistic回归模型分析显示：校正年龄、性别、收缩压、舒张压、体质量指数、三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、空腹血糖、吸烟、饮酒后，hscRP为颈动脉斑块及不稳定斑块的危险因素（均P〈0．05），hsCRP〉3～10mg／L组颈动脉斑块及不稳定斑块发生风险为hsCRP〈1mg／L组的1．30倍（95％CI1．06～1．60）和1．37倍（1．05～1．79）。结论中老年人群中，hsCRP水平升高，未来发生颈动脉斑块及不稳定斑块的风险增加，hsCRP是颈部斑块以及不稳定斑块形成的独立危险因素。
Objective To investigate the relationship between baseline high-sensitivity C-reactive protein （hsCRP） level and the detection rate of carotid artery plaque. Methods Prospective cohort study method was used in this study. A total of 5852 participants were selected from the in-service or retired employees of Kailuan Group by stratified random sampling. Those subjects aged≥40 years, and were free from the history of cerebral ischemic stroke, transient ischemic attack （lacunar infarction excluded）, myocardial infarction. The data on the unified questionnaire, blood biochemistry and carotid artery ultrasonography were collected. According to the levels of hsCRP in 200--2007, this cohort was divided into three groups： hsCRP〈 1, 1-3, 〉3-10 mg/L group. Multi- variate Logistic regression analysis was adopted to explore the relationship between hsCRP level in 2006 and the de- tection rate of carotid artery plaque in 2010. Results Compared with hsCRP〈1 mg/L group, the carotid artery plaque detection rate in groups of hsCRP 1-3 mg/L and hsCRP 〉3-10 mg/L was increased （42.6%, 50.4% vs 35.4%, P〈0.05）, so were the unstable plaque detection rate （24.0%, 28.9% vs 17.0%） and total burden score （TBS） of carotid atherosclerotic plaque [（3.05±1.86）, （3. 48±1. 82） vs （2.65±1. 76）, P〈0.05]. In the ease of hsCRP 1- 3 mg/L and 〉3-10 mg/L, TBS was significantly higher in either male or female subjects than that inhsCRP〈1 mg/L ones when grouped by sex, for male it was [（3.60±1.85）, （3.88±1.86） vs （3.16±1.66）]; while for female it was [（2.34±1.62）, （2.97±1.63） vs （1.90±1.63）, all P〈0.05]. Logistic regression analy- sis on the multiple factors which affected carotid artery plaque and unstable plaque indicated that hsCRP was the in- dependent risk factor after adjustment for age, gender, systolic blood pressure, diastolic blood pressure, body mass index, triglycerides, total cholesterol, high-density lipoprotein cholesterol, low density lipoprotein cholesterol, fast- ing blood glucose, smoking and alcohol （all P〈0.05）. The risks of carotid artery plaque and unstable plaque oc- currence were 1.30-fold （1.06-1.60） and 1.37-fold （1.05-1.79） respectively in hsCRP 〉3--10 mg/L group as compared with those in hsCRP〈1 mg/L group. Conclusions In the middle-aged and elderly population, the high hsCRP levels increase the risk of developing carotid artery plaque and unstable plaque, and hsCRP is the independent risk factor of carotid artery plaque and unstable plaque.
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2014年第5期451-456,共6页
Chinese Journal of Hypertension
关键词
高敏C反应蛋白
颈动脉斑块
颈动脉不稳定斑块
炎症
High-sensitivity C-reactive protein
Carotid artery plaque
Carotid artery unstable plaque
Inflam-mation
