Kaźmierski Radosław, Podsiadły Edyta, Tylewska-Wierzbanowska Stanisława, Kozubski Wojciech
Katedra i Klinika Neurologii, Akademia Medyczna im. K. Marcinkowskiego w Poznaniu, ul. Przybyszewskiego 49, 60-355 Poznań.
Neurol Neurochir Pol. 2005 Jul-Aug;39(4):277-86.
The aim of this study was to assess the correlation between morphological markers of carotid atherosclerosis, such as intima-media thickness (IMT) and the cross-sectional plaque area with markers of inflammation and C. pneumoniae infection.
The study involved a group of 128 persons (63 females, 49.2%), including 54 atherothrombotic stroke patients. The IMT and cross-sectional plaque area of common and internal carotid arteries were measured by ultrasonography. We assessed the C-reactive protein (CRP) and fibrinogen blood level, white blood cell (WBC) count, levels of IgA and IgG antibodies against C. pneumoniae , additionally the presence of C. pneumoniae DNA in WBCs was detected by PCR. We also considered the following risk factors: hypertension, diabetes, obesity and smoking.
The multiple regression analysis showed the strongest and independent correlations of WBC with the IMT (r=0.32; p=0.0003) and plaque area (r=0.24; p=0.008) increase. Also other factors, such as smoking (r=0.19; p=0.026), hypertension (r=0.18; p=0.023) and CRP concentration (r=0.17; p=0.036) showed a significant correlation with carotid IMT. C. pneumoniae -specific IgG antibodies level showed a significant correlation with IMT only in the linear regression analysis, but not in the multiple regression analysis. C. pneumoniae DNA presence results did not reveal a significant correlation with either IMT or the carotid plaque area.
Inflammatory markers, especially the WBC count and CRP level, showed an independent and stronger correlation with carotid atherosclerosis than markers of C. pneumoniae infection.
本研究旨在评估颈动脉粥样硬化的形态学标志物，如内膜中层厚度（IMT）和斑块横截面积与炎症标志物及肺炎衣原体感染标志物之间的相关性。
该研究纳入了128人（63名女性，占49.2%），其中包括54例动脉粥样硬化性血栓形成性卒中患者。通过超声检查测量颈总动脉和颈内动脉的IMT及斑块横截面积。我们评估了C反应蛋白（CRP）和纤维蛋白原的血液水平、白细胞（WBC）计数、抗肺炎衣原体IgA和IgG抗体水平，此外还通过聚合酶链反应（PCR）检测白细胞中肺炎衣原体DNA的存在情况。我们还考虑了以下危险因素：高血压、糖尿病、肥胖和吸烟。
多元回归分析显示，白细胞与IMT增加（r = 0.32；p = 0.0003）和斑块面积增加（r = 0.24；p = 0.008）之间存在最强且独立的相关性。其他因素，如吸烟（r = 0.19；p = 0.026）、高血压（r = 0.18；p = 0.023）和CRP浓度（r = 0.17；p = 0.036）也与颈动脉IMT存在显著相关性。仅在线性回归分析中，肺炎衣原体特异性IgG抗体水平与IMT存在显著相关性，而在多元回归分析中则不然。肺炎衣原体DNA的存在结果与IMT或颈动脉斑块面积均未显示出显著相关性。
炎症标志物尤其是白细胞计数和CRP水平，与颈动脉粥样硬化的相关性比肺炎衣原体感染标志物更强且具有独立性。
