近期感染与脑梗死发病的相关性研究

目的:探讨近期感染与脑梗死发病的关系,分析循环免疫复合物(circulatingimmunecomplex,CIC)、C反应蛋白(Creactiveprotein,CRP)、补体C4、C3、C1q与近期感染和脑梗死发病的关联。方法:调查了97例脑梗死患者与对照组83例,测定26例有近期感染史和71例无近期感染史的脑梗死病例及83例对照组的血清CIC、CRP、C4、C3、C1q含量,并进行分析。结果:经单因素Logistic回归显示:近期感染(OR,2.67;95%可信区间,1.2～5.9),CIC(OR,1.08;95%可信区间,1.03～1.12),CRP(OR,1.27;95%可信区间,1.16～1.39)水平升高,C1q(OR,0.88;95%可信区间,0.83～0.93),C3(OR,0.98;95%可信区间,0.96～0.99),C4(OR,0.93;95%可信区间,0.89～0.97)水平降低都是脑梗死的危险因素。但经多因素Logistic回归后仅CRP(OR,1.26;95%可信区间,1.12～1.43)水平升高,C1q(OR,0.88;95%可信区间,0.82～0.94),C3(OR,0.98;95%可信区间,0.96～0.99)水平降低是脑梗死的危险因素。经Spearman相关分析显示:感染与CIC有关(r=0.27,P=0.0008),与脑梗死发作有关(r=0.18,P=0.013)。脑梗死与CIC(r=0.3,P<0.0001),CRP(r=0.43,P<0.0001),C1q(r=-0.37,P=0.0001),C3(r=-0.26,P=0.0007),C4(r=-0.27,P=0.0004)水平有关。结论:感染是脑梗死的一个危险因素;循环免疫复合物CIC、CRP、补体C4、C3、C1q参与了脑梗死发病;循环免疫复合物既与感染有关联又参与了脑梗死的免疫损伤过程。

The study of correlation between preceding infection and acute cerebral infarction

Objective:The aim of this study was to investigate the relationship between cerebral infarction and recent infection and to analyze the association between circulating immune complex (CIC) and C-reactive protein (CRP) and Complement C4, C3, C1q level and cerebral infarction and preceding infection.Method:The CIC, CRP, C4, C3, C1q level at the onset of cerebral infarction in 26 cases with preceding infection and 69 cases without preceding infection and in 83 controls were tested and analyzed.Result:The results of univariate Logistic regression analysis showed that preceding infection (OR,2.67; 95%CI, 1.2-5.9), CIC(OR,1.08; 95%CI, 1.03-1.12), increased CRP(OR,1.27; 95%CI, 1.16-1.39), C1q(OR,0.88; 95%CI, 0.83-0.93), C3(OR,0.98; 95%CI, 0.96-0.99), reduced C4(OR,0.93; 95%CI, 0.89-0.97) were risk factors of cerebral infarction. The results of multivariate Logistic regression analysis showed that increased CRP(OR,1.26; 95%CI, 1.12-1.43),C1q(OR,0.88; 95%CI, 0.82-0.94), reduced C3(OR,0.98; 95%CI, 0.96-0.99) were risk factors of cerebral infarction. By Spearman’s correlation analysis, preceding infection associated with CIC level(r=0.27, P=0.0008)and occurrence of cerebral infarction(r=0.18,P=0.013). Cerebral infarction associated with CIC(r=0.3,P<0.0001), CRP (r=0.43, P<0.0001), C1q(r=-0.37, P=0.0001), C3(r=-0.26, P=0.0007) and C4(r=-0.27 P=0.0004) levels. Conclusion:Preceding infection is a risk factor for cerebral infarction. CIC, CRP, C4,C3, C1q are involved in cerebral infartion. There might be an association between the increase of CIC level and the preceding infection. The rising of CIC levels might associate with the process of immune injury of cerebral infartion.