Department of Neurology, Central Hospital of Panzhihua City, Panzhihua, Sichuan Province, 617000, China.
Department of Clinical Laboratory, Central Hospital of Panzhihua City, Panzhihua, Sichuan Province, 617000, China.
Neurosci Lett. 2018 Jan 1;662:242-246. doi: 10.1016/j.neulet.2017.10.040. Epub 2017 Oct 20.
Procalcitonin (PCT) has been found to be associated with subclinical cerebrovascular damage. The relationship between PCT levels and cerebral small vessel disease (cSVD), especially cSVD burden, has not been fully understood. This study aimed to investigate the association between PCT levels and cSVD in patients with first-ever acute ischemic stroke or transient ischemic attack (TIA).
Two hundred and seventy-eight consecutive patients were prospectively recruited during Jan 2016 to Jun 2017. Serum PCT concentrations measurement was performed after admission. The presence and burden of cSVD was determined by magnetic resonance imaging (MRI). Multivariable logistic regression was used to assess whether serum PCT levels were associated with cSVD.
The median PCT level was 0.042μg/L (interquartile range, 0.025-0.065μg/L). Univariable logistic regression analysis indicated that patients with PCT level in the top quartile, compared with the lowest quartile, were more likely to have silent lacunar infarctions [odds ratio (OR), 2.266; 95% confidence interval (CI) 1.131-4.538, P=0.021], white matter lesions (OR, 1.793; 95% CI 1.029-3.574, P=0.047), high-grade enlarged perivascular spaces (OR, 8.061; 95% CI 3.599-14.055, P=0.001) and increased total MRI cSVD burden (OR, 3.743; 95% CI 1.998-7.008, P=0.002). These results persisted even after adjusting for potential confounders.
This study demonstrated that elevated PCT levels might be associated with total MRI cSVD burden in patients with ischemic stroke or TIA.
降钙素原（PCT）已被发现与亚临床脑血管损伤有关。PCT 水平与脑小血管病（cSVD），尤其是 cSVD 负担之间的关系尚未完全清楚。本研究旨在探讨首发急性缺血性卒中和短暂性脑缺血发作（TIA）患者 PCT 水平与 cSVD 之间的关系。
2016 年 1 月至 2017 年 6 月期间前瞻性连续招募了 278 例患者。入院后进行血清 PCT 浓度测量。通过磁共振成像（MRI）确定 cSVD 的存在和负担。多变量逻辑回归用于评估血清 PCT 水平是否与 cSVD 相关。
中位数 PCT 水平为 0.042μg/L（四分位距，0.025-0.065μg/L）。单变量逻辑回归分析表明，与 PCT 水平最低四分位组相比，PCT 水平最高四分位组患者更有可能发生无症状腔隙性梗死[比值比（OR），2.266；95%置信区间（CI），1.131-4.538，P=0.021]、脑白质病变（OR，1.793；95% CI，1.029-3.574，P=0.047）、高级别扩大血管周围间隙（OR，8.061；95% CI，3.599-14.055，P=0.001）和增加的总 MRI cSVD 负担（OR，3.743；95% CI，1.998-7.008，P=0.002）。即使在调整了潜在混杂因素后，这些结果仍然存在。
本研究表明，在缺血性卒中和 TIA 患者中，升高的 PCT 水平可能与总 MRI cSVD 负担有关。
