摘要
目的:探究血清内皮细胞特异性分子1(ESM-1)、视黄醇结合蛋白4(RBP-4)、脂蛋白相关磷脂酶A2(Lp-PLA2)水平与脑梗死患者颈动脉粥样硬化斑块稳定性、神经功能缺损的相关性,并分析各指标对疗效的预测价值。方法:收集脑梗死患者127例,入院时采用酶联免疫吸附试验测定血清ESM-1、Lp-PLA2水平,采用免疫增强比浊法检测血清RBP-4水平,入院后均给予重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗,根据溶栓后第7天美国国立卫生研究院卒中量表(NIHSS)评分分为早期有效组、无效组与恶化组,分析各血清指标与斑块稳定性、NIHSS评分、脑梗死面积的相关性,并采用多元线性回归方程分析各指标对疗效的预测价值。结果:早期恶化组血清ESM-1、RBP-4、Lp-PLA2水平高于早期无效组和有效组,且早期无效组高于早期有效组(P均<0.05);不稳定斑块患者血清ESM-1、RBP-4、Lp-PLA2水平高于稳定斑块患者和无斑块患者,且稳定斑块患者高于无斑块患者(P均<0.05);神经功能重度缺损患者血清ESM-1、RBP-4、Lp-PLA2水平高于神经功能中度和轻度缺损患者,且中度患者高于轻度缺损患者(P均<0.05);大面积脑梗死患者血清ESM-1、RBP-4、Lp-PLA2水平高于中面积和小面积脑梗死患者,且中面积高于小面积脑梗死患者(P均<0.05);血清ESM-1、RBP-4、Lp-PLA2水平与斑块稳定性呈负相关,与NIHSS评分、脑梗死面积呈正相关(P均<0.05);血清ESM-1、RBP-4、Lp-PLA2水平与疗效显著相关(P均<0.05)。结论:血清ESM-1、RBP-4、Lp-PLA2水平可能成为评估脑梗死患者颈动脉粥样硬化斑块稳定性、神经功能缺损情况及疗效的生物学标志物。
Objective:To investigate the correlation between serum endothelial cell specific molecule 1(ESM-1),retinol binding proteins 4(RBP-4),lipoprotein-associated phospholipase A2(Lp-PLA2) and carotid atherosclerotic plaque stability and neurological deficit(National Institute of Health stroke scale,NIHSS) score in patients with cerebral infarction,and the effect of each index on the efficacy.Methods:A total of 127 patients with cerebral infarction in our hospital were collected,and they were all given intravenous thrombolysis with recombinant tissue-type plasminogen activator(rt-PA).According to the NIHSS score on the 7th day after thrombolysis,they were divided into the early effective group,early ineffective group and early deterioration group.The correlation between each serum index and plaque stability,NIHSS score,and cerebral infarction size was examined,and the influence of each index on the curative effect and the predictive value of the curative effect were analyzed.Results:The levels of serum ESM-1,RBP-4 and Lp-PLA2 in the early deterioration group were higher than those in the early ineffective group and the early effective group,and those in the early ineffective group was higher than in the early effective group(P<0.05).The levels of RBP-4 and Lp-PLA2 were higher in the patients with unstable plaques than those of patients with stable plaques and patients without plaques,and those in the patients with stable plaques were higher than those without plaques(P<0.05).The level of Lp-PLA2 was higher in the patients with severe neurological deficit than that in the patients with moderate neurological deficit and mild neurological deficit,and that in the patients with moderate neurological deficit were higher than in the patients mild neurological deficit(P<0.05).Serum ESM-1,RBP-4 and Lp-PLA2 were higher in patients with large-sized cerebral infarction than those of patients with medium-sized cerebral infarction and patients with small-sized cerebral infarction,and those in the patients with medium-sized cerebral infarction were higher than those with small-sized cerebral infarction(P<0.05).Serum ESM-1,RBP-4 and Lp-PLA2 levels were negatively correlated with plaque stability,and positively correlated with NIHSS score and cerebral infarction area(P<0.05).Serum ESM-1,RBP-4 and Lp-PLA2 levels were significantly correlated with curative effect(P<0.05).Conclusion:Serum ESM-1,RBP-4 and Lp-PLA2 levels may be biomarkers for evaluating carotid atherosclerotic plaque stability,NIHSS score and cerebral infarct size in patients with cerebral infarction.
作者
刘建新
薛海龙
LIU Jian-xin;XUE Hai-long(The 987th Hospital of PLA Joint Logistic Support Force,Sanxi Baoji 721000,China)
出处
《内科急危重症杂志》
2024年第1期55-58,共4页
Journal of Critical Care In Internal Medicine
基金
陕西省医学科学研究课题计划(2018JM2818)。
