Mitaki S, Nagai A, Oguro H, Yamaguchi S
Department of Neurology, Shimane University School of Medicine, Izumo, Japan.
Department of Laboratory Medicine, Shimane University School of Medicine, Izumo, Japan.
Acta Neurol Scand. 2016 Jan;133(1):68-74. doi: 10.1111/ane.12440. Epub 2015 May 14.
Inflammation has received increasing attention as a cause of stroke. Although several lines of evidence suggest that inflammatory processes have a role in arteriosclerotic vascular events, their involvement remains to be determined. The purpose of this study was to examine the associations between serum high-sensitive C-reactive protein (hs-CRP) levels and cerebral small vessel (CSV)-related lesions as a manifestation of arteriosclerosis.
Neurologically normal subjects without any history of neurologic or psychiatric diseases were enrolled (n = 519). All the participants underwent magnetic resonance imaging (MRI), and their CSV-related lesions (i.e., lacunar infarcts, cerebral microbleeds, deep white matter hyperintensity, and periventricular hyperintensity) were evaluated. The serum levels of hs-CRP were evaluated as common inflammatory markers.
Subjects with higher C-reactive protein (CRP) levels had more lacunar infarcts (P = 0.02). After adjusting for the traditional cardiovascular risk factors, higher hs-CRP levels were still associated with the presence of lacunar infarcts [odds ratio for the highest vs the lowest tertile of hs-CRP, 3.57 (95% confidence interval: 1.30-9.80)]. These associations did not change when the logarithmically transformed values for hs-CRP were included. Furthermore, subjects with higher CRP levels had more cerebral microbleeds (P = 0.03), more severe deep white matter hyperintensity (P = 0.04), and periventricular hyperintensity (P = 0.04); however, these associations were not observed after adjusting for the cardiovascular risk factors.
Higher levels of hs-CRP were associated with lacunar infarcts. Thus, inflammatory processes may be involved in the pathogenesis of small-vessel disease.
炎症作为中风的一个病因已受到越来越多的关注。尽管有几条证据表明炎症过程在动脉粥样硬化性血管事件中起作用，但其参与情况仍有待确定。本研究的目的是检查血清高敏C反应蛋白（hs-CRP）水平与作为动脉粥样硬化表现的脑小血管（CSV）相关病变之间的关联。
纳入无任何神经或精神疾病病史的神经功能正常受试者（n = 519）。所有参与者均接受了磁共振成像（MRI）检查，并对其CSV相关病变（即腔隙性梗死、脑微出血、深部白质高信号和脑室周围高信号）进行了评估。hs-CRP的血清水平作为常见炎症标志物进行评估。
C反应蛋白（CRP）水平较高的受试者有更多的腔隙性梗死（P = 0.02）。在对传统心血管危险因素进行调整后，较高的hs-CRP水平仍与腔隙性梗死的存在相关[hs-CRP最高三分位数与最低三分位数的比值比为3.57（95%置信区间：1.30 - 9.80）]。当纳入hs-CRP的对数转换值时，这些关联没有改变。此外，CRP水平较高的受试者有更多的脑微出血（P = 0.03）、更严重的深部白质高信号（P = 0.04）和脑室周围高信号（P = 0.04）；然而，在对心血管危险因素进行调整后，未观察到这些关联。
较高水平的hs-CRP与腔隙性梗死相关。因此，炎症过程可能参与了小血管疾病的发病机制。
