急性缺血性卒中患者血浆中核心蛋白聚糖浓度降低及其临床意义

Reduction of plasma decorin following acute ischemic stroke and its clinical significance

目的初步探讨急性缺血性卒中(acute ischemic stroke,AIS)患者血浆核心蛋白聚糖(decorin,DCN)浓度的变化及其临床意义。方法采用酶联免疫吸附法(ELISA)测定102例发病在7 d内的急性缺血性卒中患者及120例体检者(对照组)血浆中DCN浓度,分析DCN在卒中亚型(TOAST法)间的浓度差异以及其对缺血性卒中的诊断价值及影响。结果急性缺血性卒中的血浆DCN浓度明显低于对照组(P<0.001),且大动脉粥样硬化性卒中组DCN浓度低于同水平各组。受试者工作特征曲线(ROC)显示DCN浓度用于诊断缺血性卒中的发生有显著意义(P<0.001),选取DCN<8 500 pg/ml作为诊断缺血性卒中的诊断界值点时,敏感度为79.4%,特异度为62.8%。Logistic回归曲线分析提示DCN<8 500 pg/ml是缺血性卒中的独立危险因素(OR=4.8;95%CI:2.1～11.1;P<0.001)。结论急性缺血性卒中患者血浆中DCN浓度显著降低,其浓度变化可以对缺血性卒中的诊断、治疗提供帮助。

Objective To investigate the changes of plasma decorin in patients with acute ischemic stroke and its clinical significance.Methods The plasma levels of decorin were assessed in 102 patients with acute ischemic stroke（〈 7 days） and 120 control subjects using ELISA.Then we evaluated the relationship between decorin level and the TOAST subtypes of stroke,so as to analyze the role of decorin level in diagnosis and treatment of acute ischemic stroke.Results Compared with the control group,the decorin level was significantly decreased in acute ischemic stroke group（P〈0.001）,and that in the large-artery atherosclerosis group was lower than those in other groups of the same level.According to the receiver operating characteristic curve,decorin level was a diagnostie marker for acute ischemic stroke（P〈0.001）.Decorin levels 〈8 500 pg/mL yielded a sensitivity of 79.4% and a specificity of 62.8% for diagnosis of acute ischemic stroke.Logistic regression indicated that decorin level 〈8 500 pg/ml was an independent risk factor of acute ischemic stroke（OR=4.8;95%CI： 2.1-11.1;P〈0.001）.Conclusion Decorin level is significantly decreased in patients following acute ischemic stroke.The changes of decorin level can contribute to the diagnosis and treatment of acute ischemic stroke.