脑卒中患者血浆脂联素水平与炎性因子的关系

ADPN plasma concentration of cerebral stroke is correlated to inflammatory factors

目的研究脑卒中患者血浆脂联素（ADPN）浓度及与炎性因子的关系。方法根据临床表现、影像学和实验室结果，将136例急性脑梗死患者和39例急性脑出血患者列为研究对象。前者又分为大动脉粥样硬化性卒中组（LAA，n=77）、小动脉闭塞性卒中组（SAA，n=21），心源性脑栓塞组（CE，n=38）。同时选取30例正常对照。比较各组间血浆ADPN水平差异及ADNP与hs—CRP、IL-10的相关性。结果（1）脑梗死组患者血浆ADPN水平明显低于对照组[（6．3±2．2）mg／L，（8．9±2．7）mg／L]，差异有显著性（P〈0．05）。（2）缺血性卒中亚型不同，ADPN水平不同（F=5．21，P=0．005），CE组水平最高[（8．0±1．9）mg／L]而LAA组最低[（5．5±1．0）mg／L]。（3）脑梗死组与脑出血组间无明显差异（P=0．341）。（4）血浆ADPN水平与IL-10水平呈正相关（r=0．274，P〈0．01），与hsCRP水平呈负相关（r=-0．308，P〈0．05）。结论低ADPN血症参与了动脉粥样硬化及脑卒中的过程，与炎性因子共同参与了卒中后的炎症反应。

Objective To investigate the difference of adiponectin（ADPN） levels in cerebral stroke and the relationship with inflammatory factors. Methods Using clinical, imaging, and laboratory data, 136 consecutive patients with acute cerebral infarction were categorized into three subtypes：large-artery atheroselerosis （LAA, n = 77）, small-artery atherosclerosis （ SAA, n = 21 ） , cardioembolism （ CE, n = 38 ）. Patients of acute cerebral hemorrhage（ n =39） were also included. Clinical features, level＇s of adiponectin, IL-10 and hsCRP were compared between groups. Results ADPN level of cerebral stroke group was lower than the control group （6.3 ± 2.2 vs 8.9 ± 2.7 mg/L）. ADPN level differed by stroke subtype（F=5.21, P=0. 005）：highest in the CE group （8.0 ± 1.9 mg/L） and lowest in the LAA group（5.5 - 1.0 mg/L）. There was no significant difference between ischemic and hemorrhagic groups. ADPN level was relative to IL-10（ r = 0. 274, P〈 0.01 ） and hs-CRP（ r = -0. 308, P 〈 0.05 ）. Conclusion Hypoadiponectinemia is associated with atherosclerosis and stroke. The variation of levels of ADPN and the inflammatory factors may contribute to the inflammation after ischemic stroke.