Abstract:
ObjectiveTo investigate the correlations between serum intercellular adhesion molecule-1(ICAM-1), hypersensitive C reactive protein(hs-CRP), monocyte chemoattractant protein-1(MCP-1) and carotid artery plaque in patients with acute cerebral infarction(ACI).
MethodsOne hundred and five ACI patients were admitted, the patients' clinical data were collected, the levels of serum hs-CRP and ICAM-1 were detected by ELISA and serum MCP-1 level was detected by double antibody sandwich ELISA, and the carotid intima-media thickness(IMT) and the characteristics of carotid artery plaque were measured by carotid ultrasound.The patients were subdivided into 0.9 mm < IMT ≤ 1.2 mm group, 1.2 mm < IMT ≤ 1.4 mm group, IMT>1.4 mm group, and also divided into the stability plaque group(39 cases) and vulnerable plaque group(66 cases) according to the characteristics of the plaques.The correlations between serum hs-CRP, ICAM-1, MCP-1 and IMT were analyzed by Pearson correlation analysis.The risk factors influencing the ACI carotid atherosclerotic plaque instability were analyzed by multiple logistic regression analysis, and the value of serum hs-CRP, ICAM-1, MCP-1 levels in predicting the carotid atherosclerotic plaque instability in ACI patients were analyzed by the receiver operating characteristic(ROC) curve.
ResultsThe levels of serum hs-CRP, ICAM-1 and MCP-1 in vulnerable plaques group were higher than those in stability plaque group(P < 0.01).The levels of serum hs-CRP, ICAM-1 and MCP-1 were increased successively in the 0.9 mm < IMT ≤ 1.2 mm group, 1.2 mm < IMT ≤ 1.4 mm group, and IMT>1.4 mm group(P < 0.05 to P < 0.01).Pearson correlation analysis showed that serum hs-CRP, ICAM-1 and MCP-1 levels were positively correlated with IMT(r=0.495, 0.585, 0.498, P < 0.05).Multiple logistic regression analysis showed that the high levels of ICAM-1, hs-CRP, MCP-1, LDL-C and diabetes mellitus were the risk factors for carotid plaque instability in ACI patients(P < 0.01).ROC analysis showed that serum hs-CRP, ICAM-1 and MCP-1 levels and the combinations of the three factors which predicted the area under the curve(AUC) of carotid atherosclerotic plaque instability in ACI patients were 0.722, 0.753, 0.646 and 0.852, respectively.The sensitivity was 69.23%, 79.49%, 66.67% and 89.74%, and the specificity was 74.24%, 68.18%, 65.15% and 89.39%, respectively.
ConclusionsSerum ICAM-1, hs-CRP and MCP-1 levels are related to the characteristics of carotid atherosclerotic plaque in ACI patients, which may be used as the predictors of carotid plaque instability.