Zhang Yun, Chen Zhonglun, Tang Yufeng, Shan Wanying, Wang Ling, Shi Jian, Luo Qian, Duan Jinfeng, Xu Gelin
a Department of Neurology, Jinling Hospital , Southern Medical University , Nanjing , China.
b Department of Neurology , Mianyang Central Hospital , Mianyang , China.
Int J Neurosci. 2018 Mar;128(3):237-242. doi: 10.1080/00207454.2017.1387114. Epub 2017 Nov 3.
Procalcitonin has been suggested as a new risk factor in atherosclerotic disease. However, whether procalcitonin levels are associated with the risk of carotid atherosclerosis remains unclear. This study aimed to investigate the relationship between procalcitonin levels and carotid atherosclerosis among patients with first-ever acute ischemic stroke.
Two hundred and thirty consecutive patients were prospectively enrolled in this study. Serum procalcitonin concentrations were measured at admission for all patients. We also performed ultrasound examination to detect the mean carotid intima-media thickness, presence of carotid-wall thickening, plaque and significant stenosis. Multiple regression analysis was used to estimate the association between procalcitonin levels and carotid atherosclerosis.
The median procalcitonin concentration was 0.051 µg/L (interquartile range, 0.036-0.080 µg/L). Of the 230 patients, 102 (44.3%) had carotid-wall thickening, 113 (49.1%) had plaque and 77 (33.5%) had significant stenosis. After adjusting for all potential confounders by multiple logistic regression analysis, patients with procalcitonin levels in the fourth quartile, compared with the first quartile, were more likely to have carotid-wall thickening [odds ratio 2.288, 95% confidence intervals 1.042-5.021, P = 0.039] and significant stenosis [odds ratio 3.871, 95% confidence intervals 1.690-8.867, P = 0.003]. Furthermore, the linear regression analysis revealed a significant positive correlation between procalcitonin levels and the mean carotid intima-media thickness (β = 0.162, P = 0.012).
Higher procalcitonin concentrations at admission might be associated with carotid-wall thickening and significant stenosis in ischemic stroke patients.
降钙素原已被认为是动脉粥样硬化疾病的一种新的危险因素。然而，降钙素原水平是否与颈动脉粥样硬化风险相关仍不明确。本研究旨在探讨首次发生急性缺血性卒中患者的降钙素原水平与颈动脉粥样硬化之间的关系。
本研究前瞻性纳入了230例连续的患者。对所有患者入院时测定血清降钙素原浓度。我们还进行了超声检查以检测平均颈动脉内膜中层厚度、颈动脉壁增厚情况、斑块及显著狭窄情况。采用多元回归分析来评估降钙素原水平与颈动脉粥样硬化之间的关联。
降钙素原浓度中位数为0.051µg/L（四分位间距，0.036 - 0.080µg/L）。在230例患者中，102例（44.3%）有颈动脉壁增厚，113例（49.1%）有斑块，77例（33.5%）有显著狭窄。通过多元逻辑回归分析校正所有潜在混杂因素后，降钙素原水平处于第四四分位数的患者与第一四分位数的患者相比，更有可能出现颈动脉壁增厚[比值比2.288，95%置信区间1.042 - 5.021，P = 0.039]和显著狭窄[比值比3.871，95%置信区间1.690 - 8.867，P = 0.003]。此外，线性回归分析显示降钙素原水平与平均颈动脉内膜中层厚度之间存在显著正相关（β = 0.162，P = 0.012）。
入院时较高的降钙素原浓度可能与缺血性卒中患者的颈动脉壁增厚和显著狭窄相关。
