急性脑梗死患者血清脂联素和同型半胱氨酸与高敏C反应蛋白的临床研究

The clinical study of the serum levels of adiponectin, homocysteine and high-sensitive C-reaction protein in patients with acute cerebral infarction

目的 探讨急性脑梗死（ACI）患者血清脂联素、同型半胱氨酸（Hcy）和高敏C反应蛋白（hs-CRP）水平的变化及临床意义.方法 选择ACI患者100例,按脑梗死体积及神经功能缺损程度分别分为3个亚组,选择同期健康体检者35例作为正常对照组.用酶联免疫吸附法检测血清脂联素和Hcy水平,应用免疫比浊法测定血清hs-CRP水平,并对结果进行比较.结果 ACI组血清脂联素水平（6.4±1.5）mg/L明显低于正常对照组的（12.5±2.3）mg/L,差异有统计学意义（P＜0.05）;小梗死组（28例）、中梗死组（42例）、大梗死组（30例）患者血清脂联素水平[（8.8±1.9）、（5.6±1.3）、（2.7±0.8）mg/L]逐渐降低,轻型组（27例）、中型组（42例）、重型组（31例）患者[（8.5±1.7）、（5.4±1.1）、（2.5±0.7）mg/L]亦逐渐降低,差异均有统计学意义（均P＜0.05）.ACI组血清Hcy和hs-CRP水平明显高于正常对照组,差异均有统计学意义（均P＜0.05）;小梗死组、中梗死组、大梗死组患者血清Hcy和hs-CRP水平逐渐升高,轻型组、中型组、重型组患者亦逐渐升高,差异均有统计学意义（均P＜0.05）.结论 血清脂联素、Hcy及hs-CRP参与了ACI的发病;并且它们的水平与脑梗死体积及神经功能缺损程度密切相关,检测这3个指标有助于对ACI患者病情及预后做出正确的判断.

Objective To investigate the clinical significance of serum levels of adiponectin （APN）,homocysteine（Hcy） and high-sensitive C-reaction protein （hs-CRP） in patients with acute cerebral infarction（ACI）.Methods One hundred patients with ACI were selected and divided into different groups according to the size of infarction and clinical neurologic impairment degree score. 35 healthy people were used as control group. APN and Hcy concentrations were detected by enzyme-linked immunosorbent assay （ELISA）. The serum hs-CRP level was detected by immunoturbidimetry. Results The serum APN levels in the patients with ACI were significantly lower than those in the healthy subjects（P〈0.05）. The serum levels of APN decreased steply with the volume of infarction;the serum levels of APN decreased steply with the clinical neurologic impairment degree score,the differences of APN levels between the groups were significant （all P〈0.05）. The serum Hcy and hs-CRP levels in the patients with ACI were significantly higher than those in the healthy subjects（12.5 ± 2.3）mg/L（P〈0.05）. The serum levels of Hcy and hs-CRP increased steply with the volume of infarction [（8.8 ± 1.9） mg/L,（5.6 ± 1.3） mg/L,（2.7 ±0.8）mg/L];the serum levels of Hcy and hs-CRP increased steply with the clinical neurologic impairment degree score [（8.5±1.7）mg/L,（5.4±1.1）mg/L,（2.5±0.7）mg/L],the differences of levels of Hcy and hsCRP between two groups were significant （all P〈0.05）. Conclusions The APN,Hcy and hs-CRP may play an important role in the pathogenesis of ACI. The serum level of APN,Hcy and hs-CRP is closely correlated with the volume of infarction and the clinical neurologic impairment degree score,which may be of great value in predicting acute cerebral infarction and the severity of cerebral infarction.