缺血性脑卒中患者血清瘦素水平与颈动脉粥样硬化的研究

目的探讨急性缺血性脑卒中患者血清瘦素水平与颈动脉粥样硬化(CAS)的关系。方法选择急性缺血性脑卒中患者476例,根据颈动脉彩色超声结果分为CAS组322例和非CAS组154例。CAS组根据CAS的严重程度分为:轻度CAS 161例、中度CAS 114例和重度CAS 47例;根据超声检查分为:硬斑块127例、软斑块65例和混合斑块130例。分析组间血清瘦素水平与颈动脉斑块严重程度、斑块性质的相关性。结果 CAS组血清瘦素水平明显高于非CAS组,差异有统计学意义(P<0.05)。Logistic回归分析,血清瘦素水平升高是CAS形成的独立危险因素。中度和重度CAS患者血清瘦素水平明显高于轻度CAS患者(P<0.01)。Spearman等级相关分析,CAS严重程度与血清瘦素水平呈正相关(r=0.366,P<0.01)。结论血清瘦素水平的升高能预测CAS的发生,并能评估CAS的严重程度,但尚不能作为评估CAS斑块稳定性的可靠指标。

Relation between leptin and carotid atherosclerosis in ischemic stroke patients

Objective To investigate the relationship between the serum level of leptin and carotid atherosclerosis（CAS） in patients with ischemic stroke. Methods 476 acute ischemic stroke patients were divided into CAS group （n=322） and non-CAS group （n=154） according to carotid color ultrasonographic findings. Patients in CAS group were further divided into mild CAS group （n=161）, moderate CAS group （n=114）, severe CAS group （n=47） according to the severity of CAS, and into hard plaque group （n=127）, soft plaque group （n=65）, mixed plaque group （n=130） according to the findings of ultrasonography. Relation of serum level of leptin with severity of CAS and nature of plaque were analyzed. Results The serum leptin level was significantly higher in CAS group than in non-CAS group （P〈0.05）. Logistical regression analysis showed that elevated serum leptin level was an independent predictor for CAS. The serum leptin level was significantly higher in moderate CAS group and severe CAS than in mild CAS group （P〈0.01）. Spearman rank correlation analysis revealed that the severity of CAS was positively related with the serum leptin level （r=0.366, P〈0.01）. Conclusion Elevated serum leptin level can predict the occurrence of CAS and assess its severity, but is not a reliable indicator for the stability of carotid artery plaques.