摘要
目的:探讨瘦素与脑梗死危险因素之间的关系,为脑梗死的康复干预提供参考数据。方法:选择86例急性脑梗死患者为观察对象,为华北煤炭医学院附属医院2004-02/2005-02收治。测定其急性期血清中的瘦素、胰岛素、血糖、胰岛素敏感指数、血脂等水平,与同期健康体检者31例(对照组)对照,进行血清瘦素与脑梗死危险因素之间的直线相关和回归分析。结果:117例受试者全部进入结果分析。①脑梗死组与对照组相比,缺血性脑卒中组的三酰甘油、载脂蛋白B、收缩压,舒张压、血糖、胰岛素、肿瘤坏死因子-α均高于对照组[(1.96±0.56),(1.10±0.64)mmol/L;(1.26±0.46),(1.01±0.24)mmol/L;(150.3±16.7),(129.5±17.9)mmHg;(90.4±9.7),(80.6±9.0)mmHg;(7.05±2.22),(5.39±0.88)mmol/L;(19.75±8.06),(11.22±3.35)mIU/L;(3.96±2.81),(2.28±3.11)μg/L],统计学检验差异有显著性(P<0.01)。缺血性脑卒中组的胰岛素敏感指数、高密度脂蛋白胆固醇水平明显低于对照组[(-0.94±0.52),(-1.89±0.79);(0.99±0.36),(1.35±0.27)mmol/L],统计学检验差异有显著性(P<0.01)。②单因素相关分析显示,瘦素与性别、三酰甘油、载脂蛋白B、血压、血糖、胰岛素、肿瘤坏死因子-α显著正相关(r=-0.441,0.403,0.386,0.582,0.324,0.539,0.266,0.469,P<0.001),与胰岛素敏感指数、高密度脂蛋白胆固醇水平显著负相关(r=-0.663,-0.381,P<0.001)。③以有无缺血性脑卒中为应变量,其他指标为自变量进行多因素非条件Logistic回归,缺血性脑卒中与年龄、瘦素、肿瘤坏死因子α、收缩压、三酰甘油呈正相关,与胰岛素敏感指数呈负相关。统计学检验差异有显著性(P<0.05)。④以瘦素为应变量,其他指标为自变量进行多元逐步回归显示,瘦素与性别、体质量指数、腰臀比、收缩压、三酰甘油、肿瘤坏死因子α呈正相关,与胰岛素敏感指数负相关。统计学检验差异有显著性(P<0.05)。结论:①瘦素与脑梗死危险因素之间的关系密切,可能通过影响脑梗死危险因素而参与了脑梗死的发生发展。②瘦素也可能是缺血性脑卒中独立的危险因素。
AIM： To investigate the correlation of the leptin with the risk factors of cerebral infarction in order to provide reference data for rehabilitative intervention of cerebral infarction.
METHODS： Eighty-six patients with acute cerebral infarction （cerebral infarction group） and thirty-one synchronous health examinees （control group） were collected from the Affiliated Hospital of North China Coal Medical College between February 2004 and February 2005. The levels of leptin, insulin, blood sugar and insulin sensitivity index （ISI） were detected in all the subjects. Linear correlation and regression analyses were performed.
RESULTS： All the 117 subjects were involved in the result analysis. （1） The levels of triacylglycerol （TG）,Apolipoprotein B （Apo B）,systolic blood pressure （SBP）,diastalic blood pressure（DBP）,blood sugar, insulin and tumor necrosis factor-alpha （TNF-α） were significantly higher in the cerebral infarction group than in the control group [（1.96±0.56）,（1.10±0.64） mmol/L; （1.26±0.46）,（1.01±0.24） mmol/L;（150.3±16.7）,（129.5±17.9） mm Hg; （90.4 ±9.7）,（80.6±9.0） mm Hg;（7.05±2.22）,（5.39±0.88） mmol/L;（19.75±8.06）, （11.22±3.35） mIU/L;（3.96±2.81）,（2.28±3.11） μg/L], with the significant difference （P 〈 0.01）.However, the levels of ISI and high-density lipoprotein （HDL） cholesterol were signifieantly lower in the cerebral infarction group than in the control group [（-0.94±0.52）, （-1.89±0.79）;（0.99±0.36）, （1.35±0.27） mmol/L], with the significant difference （P 〈 0.01）. （2）The single factor correlation analysis showed that the leptin had positively eon＇elation with the gender, TG, Apo B, blood pressure, blood sugar, insulin and TNF- α （r=0.441, 0.403, 0.386, 0,582, 0.324,0.539,0.266, 0.469,P 〈 0.001）, and the leptin had negatively correlation with ISI and HDL cholesterol level （r=-0.663, -0.381,P 〈 0.001）. （3）Taking the occurrence of ischemic stroke as the dependent variable and other markers as the independent variables, the multiple non-conditional Logistic regression analysis was performed and showed that ischemic stroke was positively correlated with age, leptin, TNF-α, SBP and TG, while negatively correlated with ISI, with the significant difference （P 〈 0.05）. （4）Taking leptin as the dependent variable and other markers as independent variables, multiple stepwise regression analysis was performed and showed that the leptin was positively correlated with gender, body mass index, waist-to-hip ratio, SBP, TG and TNF-α,while negatively correlated with ISI, with the significant difference （P 〈 0.05）.
CONCLUSION： （1）Leptin is closely related with the risk factors of cerebral infarction. It is possibly involved in the occurrence and progress of cerebral infarction by influencing the risk factor. （2）Leptin also could be an independent risk factor of cerebral infarction.
出处
《中国临床康复》
CSCD
北大核心
2006年第10期113-115,共3页
Chinese Journal of Clinical Rehabilitation
