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Neurology:高敏C反应蛋白水平可预测颅内动脉狭窄患者接受双联抗血小板治疗效果

2018-01-13 zhangfan MedSci原创

研究认为颅内动脉狭窄伴无hsCRP水平升高患者接受双联抗血小板治疗效果更佳

近日研究人员针对颅内动脉狭窄(ICAS)的、接受氯吡格雷治疗的急性非致残性脑血管事件高危患者,考察了高敏感性C反应蛋白(hsCRP)与双抗血小板治疗的疗效与安全性之间的关系。

807名患者接受磁共振血管造影及hsCRP检测,采用COX比例风险模型考察hsCRP水平与双或单药抗血小板治疗效果之间的关系。

研究队列包含358名ICAS患者(44.4%)和449名非 ICAS患者(55.6%)。ICAS患者其hsCRP水平高的比例较大(40.2% vs 30.1%, p = 0.003)。调整混杂因素后,ICAS患者中,hsCRP水平与中风后抗血小板治疗的效果相关(p = 0.012),对于非ICAS患者无关(p = 0.256)。相比于阿司匹林单药,氯吡格雷联用阿司匹林仅对ICAS伴无hsCRP水平升高的患者表现出显著的降低中风复发风险的能力(aHR 0.27; 95% CI 0.11-0.69; p = 0.006)。hsCRP水平对复合血管事件的研究结果相似。组间出血事件无显著性差异。

研究认为颅内动脉狭窄伴无hsCRP水平升高患者接受双联抗血小板治疗效果更佳。

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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Wed Jan 24 07:04:36 CST 2018, time=2018-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=279055, encodeId=b5db2e90550f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=153, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfBfgWn9nXBgH1sNSiaOAKhsKpN40jDHQKqcRzovau5VibLvREN8uxnu9sKoScBicHSiaDMmbveibFdrBiaD4k4IOPwlG/0, createdBy=b5d11730951, createdName=Jackie Li, createdTime=Tue Jan 16 11:26:07 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1297827, encodeId=6678129e82749, content=<a href='/topic/show?id=4eca5598c7' target=_blank style='color:#2F92EE;'>#C反应蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5598, encryptionId=4eca5598c7, topicName=C反应蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=20b5274, createdName=JR19860219, createdTime=Sun Jan 14 22:28:00 CST 2018, time=2018-01-14, status=1, ipAttribution=)]
    2018-09-11 yinhl1978
  5. 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    2018-02-28 一个字-牛

    学习了谢谢分享

    0

  6. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Wed Jan 24 07:04:36 CST 2018, time=2018-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=279055, encodeId=b5db2e90550f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=153, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfBfgWn9nXBgH1sNSiaOAKhsKpN40jDHQKqcRzovau5VibLvREN8uxnu9sKoScBicHSiaDMmbveibFdrBiaD4k4IOPwlG/0, createdBy=b5d11730951, createdName=Jackie Li, createdTime=Tue Jan 16 11:26:07 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1297827, encodeId=6678129e82749, content=<a href='/topic/show?id=4eca5598c7' target=_blank style='color:#2F92EE;'>#C反应蛋白#</a>, beContent=null, 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    2018-02-18 sunsmile 2017

    学习了

    0

  7. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Wed Jan 24 07:04:36 CST 2018, time=2018-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=279055, encodeId=b5db2e90550f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=153, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfBfgWn9nXBgH1sNSiaOAKhsKpN40jDHQKqcRzovau5VibLvREN8uxnu9sKoScBicHSiaDMmbveibFdrBiaD4k4IOPwlG/0, createdBy=b5d11730951, createdName=Jackie Li, createdTime=Tue Jan 16 11:26:07 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1297827, encodeId=6678129e82749, content=<a href='/topic/show?id=4eca5598c7' target=_blank style='color:#2F92EE;'>#C反应蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5598, encryptionId=4eca5598c7, topicName=C反应蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=20b5274, createdName=JR19860219, createdTime=Sun Jan 14 22:28:00 CST 2018, time=2018-01-14, status=1, ipAttribution=)]
    2018-01-24 sunsmile 2017

    学习了

    0

  8. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Wed Jan 24 07:04:36 CST 2018, time=2018-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=279055, encodeId=b5db2e90550f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=153, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfBfgWn9nXBgH1sNSiaOAKhsKpN40jDHQKqcRzovau5VibLvREN8uxnu9sKoScBicHSiaDMmbveibFdrBiaD4k4IOPwlG/0, createdBy=b5d11730951, createdName=Jackie Li, createdTime=Tue Jan 16 11:26:07 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1297827, encodeId=6678129e82749, content=<a href='/topic/show?id=4eca5598c7' target=_blank style='color:#2F92EE;'>#C反应蛋白#</a>, beContent=null, 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    2018-01-24 1209e435m98(暂无昵称)

    学习了.谢谢分享

    0

  9. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Wed Jan 24 07:04:36 CST 2018, time=2018-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=279055, encodeId=b5db2e90550f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=153, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfBfgWn9nXBgH1sNSiaOAKhsKpN40jDHQKqcRzovau5VibLvREN8uxnu9sKoScBicHSiaDMmbveibFdrBiaD4k4IOPwlG/0, createdBy=b5d11730951, createdName=Jackie Li, createdTime=Tue Jan 16 11:26:07 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1297827, encodeId=6678129e82749, content=<a href='/topic/show?id=4eca5598c7' target=_blank style='color:#2F92EE;'>#C反应蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5598, encryptionId=4eca5598c7, topicName=C反应蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=20b5274, createdName=JR19860219, createdTime=Sun Jan 14 22:28:00 CST 2018, time=2018-01-14, status=1, ipAttribution=)]
    2018-01-16 Jackie Li

    学习

    0

  10. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Wed Jan 24 07:04:36 CST 2018, time=2018-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=279055, encodeId=b5db2e90550f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=153, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfBfgWn9nXBgH1sNSiaOAKhsKpN40jDHQKqcRzovau5VibLvREN8uxnu9sKoScBicHSiaDMmbveibFdrBiaD4k4IOPwlG/0, createdBy=b5d11730951, createdName=Jackie Li, createdTime=Tue Jan 16 11:26:07 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1297827, encodeId=6678129e82749, content=<a href='/topic/show?id=4eca5598c7' target=_blank style='color:#2F92EE;'>#C反应蛋白#</a>, beContent=null, 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背景和目的:轻型脑卒中和短暂性脑缺血发作后,致残性卒中的发生率较高。研究者旨在探讨超敏C反应蛋白(hsCRP)预测卒中复发和不良功能预后中的作用。方法:在急性非致残性脑血管事件高危患者氯吡格雷试验中(CHANCE),来自73个(64%)预先设定的中心3044例(59%)患者,测定其hsCRP水平。主要预后为90天内发生卒中。次要预后包括联合血管事件和残疾或死亡(定义为90天改良Rankin量表评分

PLoS One:急性缺血性脑卒中患者,高血浆hsCRP水平与不良临床预后独立相关

背景:尽管由于脑梗死后炎症反应使得血浆C反应蛋白(CRP)升高,但急性缺血性卒中后的C反应蛋白与临床预后的关系仍不明朗。本研究旨在探讨血浆高敏C反应蛋白(hsCRP)水平是否独立于传统的危险因素和急性卒中后感染,与临床结局相关。方法:研究者前瞻性纳入3653例首发缺血性脑卒,这些患者功能独立,并且症状开始24h内入院。入院时检测血浆hsCRP水平,将血浆hsCRP水平分为四分位数。采用Logist

Lancet:高敏C反应蛋白浓度可预测康纳单抗治疗后心肌梗死患者预后

研究发现高敏C反应蛋白浓度是评估康纳单抗治疗效果的有效方法,炎症指标越低的患者,其接受康纳单抗治疗的效果越好

JAHA:炎症生物标志物白细胞介素-6和C反应蛋白与稳定冠状动脉心脏病结局分析!

IL-6是上游炎症标志物,与冠状动脉硬化性心脏病患者的主要不良心血管事件、心血管和全因死亡率、心肌梗塞、心力衰竭和癌症死亡率的风险独立相关。 IL-6可能反映了发生这些事件的病理生理过程。

CCLM:儿童CRP,LEP和LEPR基因多态性与高敏C反应蛋白水平的关系

近日,国际杂志《Clinical Chemistry and Laboratory Medicine》在线发表了一篇关于儿童CRP,LEP和LEPR基因多态性与高敏C反应蛋白水平的关系的研究。调查了健康西班牙儿童的两个独立队列中C反应蛋白(CRP),瘦素(LEP)和瘦素受体(LEPR)基因中单核苷酸多态性(SNPs)与高敏感性CRP(hs-CRP)水平的关系。

BMJ Open Heart:高敏C反应蛋白可作为轻度中度主动脉瓣狭窄患者降脂的预后指标

在“辛伐他汀、依泽替米贝在主动脉狭窄中应用”实验(Simvastatin and Ezetimibe in Aortic Stenosis ,SEAS)中,为了评估轻到重度主动脉瓣狭窄的患者在使用上述药物或安慰剂后高敏C反应蛋白在患者的预后的预测价值。研究人员对SEAS中1620个患者进行了分组研究。    在1620个SEAS患者中,研究者测量了他们的血脂

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