【摘要】 目的 探讨血清补体C1q/肿瘤坏死因子相关蛋白3(Complement-C1q TNF-related protein 3,CTRP3)、补体C1q/肿瘤坏死因子相关蛋白9(Complement-C1q TNF-related protein 9,CTRP9)水平与缺血性脑卒中(Cerebral ischemic stroke,CIS)患者颈动脉支架成形术(Carotid artery stenting,CAS)后支架内再狭窄(In-stent restenosis,ISR)的关系。方法 选取2018年2月-2021年2月在廊坊市人民医院诊治的234例CIS患者为CIS组，其中CAS后1年内出现ISR的患者作为ISR组(42例),未出现ISR的患者作为NISR组(192例);另选择同期体检健康者85例为对照组；检测CIS患者入院后CAS术前、体检健康者体检时血清CTRP3、CTRP9水平；收集CIS患者的临床资料；分析CIS患者血清CTRP3,CTRP9水平与临床指标的相关性、CAS后发生ISR的影响因素，血清CTRP3,CTRP9水平对CIS患者CAS后发生ISR的预测价值。结果 与对照组比较，CIS组血清CTRP3,CTRP9水平降低(P<0.05);与NISR组比较，ISR组血清CTRP3,CTRP9水平降低，术前超敏C反应蛋白(High sensitivity C-reactive protein,hs-CRP)、术前白细胞计数、术前中性粒细胞计数、支架数量、残留狭窄程度比例升高(P<0.05);CIS患者血清CTRP3,CTRP9水平与术前hs-CRP水平、术前白细胞计数、术前中性粒细胞计数、支架数量、残留狭窄程度均呈负相关(r<-0.318,P<0.05);支架数量多、血清CTRP3低水平、CTRP9低水平为CIS患者CAS后发生ISR的危险因素(P<0.05);血清CTRP3,CTRP9、二者联合预测CIS患者CAS后发生ISR的曲线下面积分别为0.811、0.798、0.934,二者联合的预测价值显著高于单一指标(P<0.05)。结论 术前血清CTRP3,CTRP9水平异常降低与CIS患者CAS后发生ISR有关，可作为CIS患者CAS后预后评估的生物学指标。更多还原

【Abstract】 Objective To investigate the relationship between serum Complement-C1 q TNF-related protein 3(CTRP3), Complement-C1 q TNF-related protein 9(CTRP9) levels and in-stent restenosis(ISR) after carotid artery stenting(CAS) in cerebral ischemic stroke(CIS) patients. Methods 234 patients with CIS treated in Langfang people’s Hospital from February 2018 to February 2021 were selected as CIS group, of which patients with ISR within 1 year after CAS were selected as ISR group(42 cases) and patients without ISR were selected as NISR group(192 cases). In addition, 85 healthy persons in the same period were selected as the control group. The levels of serum CTRP3, CTRP9 were measured in patients with CIS before CAS and in healthy subjects during physical examination; collect the clinical data of CIS patients; analyze the correlation between the levels of serum CTRP3, CTRP9 in patients with CIS and clinical indicators, influencing factors of ISR after CAS, and predictive value of serum CTRP3 and CTRP9 levels for ISR after CAS in patients with CIS. Results Compared with the control group, the levels of serum CTRP3 and CTRP9 in CIS group decreased(P<0.05); compared with NISR group, the levels of serum CTRP3 and CTRP9 in ISR group decreased, and the proportion of preoperative high sensitivity-C reactive protein(hs-CRP), preoperative leukocyte count, preoperative neutrophil count, number of supports and proportion of residual stenosis increased(P<0.05); the levels of serum CTRP3 and CTRP9 in patients with CIS were negatively correlated with preoperative hs-CRP, preoperative leukocyte count, preoperative neutrophil count, number of supports and degree of residual stenosis(P<0.05); the large number of supports, the low level of serum CTRP3 and CTRP9 were the risk factors of ISR after CAS in patients with CIS(P<0.05); the areas under curve of serum CTRP3, CTRP9 and their combination in predicting ISR after CAS in patients with CIS were 0.811, 0.798 and 0.934 respectively, the predictive value of their combination was significantly higher than that of a single index(P<0.05). Conclusion The abnormal decrease of preoperative serum CTRP3 and CTRP9 levels is related to ISR after CAS in patients with CIS, which can be used as a biological index for the evaluation of prognosis after CAS in patients with CIS.更多还原