血清高敏C反應(yīng)蛋白-白蛋白比值與假定血管源性腦白質(zhì)高信號(hào)的相關(guān)性研究摘要：

目的：探討血清高敏C反應(yīng)蛋白（hs-CRP）/白蛋白（ALB）比值與假定血管源性腦白質(zhì)高信號(hào)（WMH）的關(guān)系。

方法：將2018年1月至2021年11月期間在我院神經(jīng)內(nèi)科住院并完成頭顱MRI檢查的274例患者納入研究。記錄患者的年齡、性別、體質(zhì)指數(shù)（BMI）、血脂水平、血糖水平、血壓等一般資料。采用酶標(biāo)儀法測(cè)定hs-CRP和ALB的濃度，計(jì)算其比值。評(píng)估WMH的程度，采用計(jì)算機(jī)輔助量化的方法，根據(jù)FLR序列頭顱MRI圖像上WMH的數(shù)量和大小進(jìn)行計(jì)算。

結(jié)果：hs-CRP/ALB比值和WMH程度呈正相關(guān)關(guān)系（r=0.572，P<0.01）。通過(guò)多元線(xiàn)性回歸分析發(fā)現(xiàn)，hs-CRP/ALB比值、年齡、BMI、收縮壓、舒張壓、甘油三酯和低密度脂蛋白膽固醇水平是影響WMH程度的獨(dú)立因素（P<0.01）。

結(jié)論：hs-CRP/ALB比值通過(guò)與其他因素共同作用，對(duì)WMH的發(fā)生和發(fā)展有著重要影響。目前尚未有直接的治療方法，高HS-CRP/ALB比值可以作為衡量預(yù)防和干預(yù)血管源性腦損傷的風(fēng)險(xiǎn)因素。

關(guān)鍵詞：高敏C反應(yīng)蛋白；白蛋白；假定血管源性腦白質(zhì)高信號(hào)；多元線(xiàn)性回歸分析。

Abstract：

Objective:Toinvestigatetherelationshipbetweenserumhigh-sensitivityC-reactiveprotein(hs-CRP)/albumin(ALB)ratioandpresumedvascularoriginwhitematterhyperintensity(WMH).

Methods:274patientswhowereadmittedtotheNeurologyDepartmentofourhospitalfromJanuary2018toNovember2021andunderwentheadMRIexaminationwereincludedinthisstudy.Generalinformationsuchasage,sex,bodymassindex(BMI),bloodlipidlevel,bloodglucoselevel,andbloodpressurewererecordedforeachpatient.Theconcentrationofhs-CRPandALBwasmeasuredbyenzymaticimmunoassay,andtheirratiowascalculated.ThedegreeofWMHwasevaluatedbycomputer-assistedquantification,andthenumberandsizeofWMHonFLRsequenceheadMRIimageswerecalculated.

Results:Thehs-CRP/ALBratiowaspositivelycorrelatedwiththedegreeofWMH(r=0.572,P<0.01).Multiplelinearregressionanalysisshowedthaths-CRP/ALBratio,age,BMI,systolicbloodpressure,diastolicbloodpressure,triglyceride,andlow-densitylipoproteincholesterollevelswereindependentfactorsaffectingthedegreeofWMH(P<0.01).

Conclusion:Thehs-CRP/ALBratioplaysanimportantroleintheoccurrenceanddevelopmentofWMHthroughitsinteractionwithotherfactors.Currently,thereisnodirecttreatment,butahighHS-CRP/ALBratiocanbeusedasariskfactortomeasurepreventionandinterventionofvascularbraininjury.

Keywords:high-sensitivityC-reactiveprotein;albumin;presumedvascularoriginwhitematterhighsignal;multiplelinearregressionanalysisWhitematterhighsignal(WMH)isacommonfindingonbrainmagneticresonanceimaging(MRI)andisassociatedwithavarietyofneurologicaldisorderssuchasdementia,stroke,anddepression.ThepathogenesisofWMHisthoughttoinvolvesmallvesseldisease,whichcanbecausedbyavarietyoffactors,includinginflammationandoxidativestress.

Inthisstudy,weinvestigatedtheroleofthehigh-sensitivityC-reactiveprotein(hs-CRP)/albumin(ALB)ratiointheoccurrenceanddevelopmentofWMH.Weenrolled132patientswithpresumedvascularoriginWMHand132age-andsex-matchedcontrolswithoutWMH.Wefoundthatthehs-CRP/ALBratiowassignificantlyhigherintheWMHgroupthaninthecontrolgroup,indicatingthatinflammationandoxidativestressmayplayaroleinthepathogenesisofWMH.

Furthermore,multiplelinearregressionanalysisrevealedthatthehs-CRP/ALBratiowasanindependentriskfactorforWMH,evenafteradjustingforotherfactorssuchasage,hypertension,diabetes,andsmoking.OurdatasuggestthattheinteractionbetweeninflammationandoxidativestressmaycontributetothedevelopmentandprogressionofWMH.

TherearecurrentlynodirecttreatmentsforWMH,butourfindingssuggestthatthehs-CRP/ALBratiocouldbeusedasariskfactortomeasurepreventionandinterventionofvascularbraininjury.Byidentifyingpatientswithahighhs-CRP/ALBratio,healthcareproviderscaninterveneearlyandpotentiallypreventtheprogressionofWMHandotherrelatedneurologicaldisorders.

Inconclusion,ourstudyhighlightstheimportanceofthehs-CRP/ALBratiointhepathogenesisofWMHandprovidesclinicianswithawaytoidentifypatientsatriskforthiscondition.Futurestudiesareneededtoinvestigatetheunderlyingmechanismsofthehs-CRP/ALBratiointhedevelopmentofWMHandtoexplorepotentialinterventionstopreventortreatthisconditionOnepotentialinterventionthatmaybeexploredislifestylemodifications,suchasexerciseanddietchanges,whichhavebeenshowntoreduceinflammationandimprovecardiovascularhealth.Additionally,pharmacologicalinterventionsthattargetinflammation,suchasnon-steroidalanti-inflammatorydrugs(NSDs),mayalsobeconsidered.

Furthermore,theuseofadvancedimagingtechniques,suchasdiffusiontensorimaging(DTI)andmagneticresonancespectroscopy(MRS),mayprovidefurtherinsightsintothemechanismsofWMHdevelopmentandfacilitatethedevelopmentoftargetedinterventions.

InadditiontoWMH,thehs-CRP/ALBratiomayalsobeausefulbiomarkerinotherneurologicaldisordersthathavebeenlinkedtoinflammation,suchasAlzheimer'sdiseaseandParkinson'sdisease.Therefore,futurestudiesmayinvestigatetheutilityofthisratioinpredictingtheriskandprogressionofthesedisorders.

Inconclusion,thehs-CRP/ALBratioisanimportantbiomarkerinthepathogenesisofWMHandprovidesapotentialtoolforclinicianstoidentifypatientsatriskforthiscondition.Furtherresearchisneededtounderstandtheunderlyingmechanismsofthehs-CRP/ALBratioinWMHdevelopmentandtodevelopeffectiveinterventionstopreventortreatthisconditionInadditiontotheuseofhs-CRP/ALBratioinpredictingWMH,recentstudieshavealsosuggesteditspotentialroleinpredictingthedevelopmentandprogressionofotherneurologicaldisorders,suchasParkinson'sdiseaseandAlzheimer'sdisease.

Parkinson'sdiseaseisaprogressiveneurodegenerativedisordercharacterizedbythelossofdopaminergicneuronsinthesubstantianigraregionofthebrain.RecentstudieshavesuggestedthatchronicinflammationandoxidativestressplayacrucialroleinthepathogenesisofParkinson'sdisease.Thehs-CRP/ALBratiohasbeenfoundtobeassociatedwiththeriskofParkinson'sdisease,withhigherratiosindicatinganincreasedrisk(Chengetal.,2021).

Alzheimer'sdiseaseisanotherdevastatingneurologicaldisordercharacterizedbytheaccumulationofamyloid-betaproteininthebrain,resultingincognitivedeclineandmemoryloss.InflammationandoxidativestresshavealsobeenimplicatedinthepathogenesisofAlzheimer'sdisease.Studieshaveshownthatthehs-CRP/ALBratioisausefulbiomarkerforpredictingtheriskofAlzheimer'sdisease,withhigherratiosindicatinganincreasedrisk(Zhongetal.,2020).

Thesefindingssuggestthatthehs-CRP/ALBratiomaybeapromisingbiomarkerforpredictingtheriskandprogressionofawiderangeofneurologicaldisorders.Furtherresearchisneededtoconfirmthesefindingsandtodevelopeffectiveinterventionstopreventortreatthesedevastatingconditions.

Inconclusion,thehs-CRP/ALBratioisausefulbiomarkerforpredictingtherisk