脑梗死相关蛋白与ACI患者脑血管狭窄程度的多因素分析

The cox regression between infarct-related protein and acute cerebral infarction in patients with cerebralvascular stenosis

目的研究脑梗死相关蛋白在评估急性脑梗死(ACI)患者脑血管狭窄程度中的作用。方法选取2010-2012年在珠江医院因ACI住院的患者,选取脑动脉造影结果狭窄程度>70%及闭塞者为试验组(n=29),≤70%者及正常者为对照组(n=23)。检测所有患者外周血脑梗死相关蛋白含量。结果试验组患者超敏C反应蛋白(hs-CRP)、血栓前体蛋白(TpP)、脂蛋白α(Lpα)外周血中含量分别为(3.51±2.25)mg/L、(1797.08±162.35)μg/L、(363.81±218.34)mg/L,均较对照组明显升高,差异有统计学意义(P<0.05)。D-二聚体(DDI)、纤维蛋白原(Fg)、血小板凝聚因子(vWF)的含量无明显变化。hs-CRP(P=0.029,OR=2.232)、TpP(P=0.032,OR=1.014)、Lpα(P=0.024,OR=1.009)与脑大动脉粥样硬化病变导致的脑血管狭窄程度相关,DDI(P=0.671)、Fg(P=0.248)、vWF(P=0.090)与脑血管的狭窄程度相关性不明显。高血压(P=0.029,OR=4.582)是脑血管狭窄的危险因素。结论 hs-CRP、TpP、Lpα、高血压是脑大动脉粥样硬化病变导致的ACI患者脑血管重度狭窄的危险因素,血清中hs-CRP、TpP、Lpα含量升高同时伴有高血压的ACI患者脑血管重度狭窄的可能性增大。

Objective To study the role of infarct-related proteins in the assessment of the degree of stenosis in acute cerebral infarction and cerebrovascular. Methods Patients with acute cerebral infarction in Zhujiang hospital between the period 2010 to 2012 were randomly divided into two groups according to the result of cerebral angiography which cerebral arterial stenosis 〉70% and cerebral artery occlusion as the experimental group and which cerebral arterial stenosis ≤ 70% and normal as the control group. The peripheral blood expressions of proteins were tested in all the patients with actue cerebral infarction. Results The content of hs-CRP [（3.51±2.25）mg/L], TpP [（1 797.08±162.35）tLg/L] and Lpot [ （363.81±218.34）mg/L] were higher in peripheral blood of experimental group then the content of DDI, Fg, vWF had no detectable change between the two groups, hs-CRP（P=0.029,OR=2.232）, TpP（P=0.032,OR=1.014） and Lpα（P= 0.024,OR=1.009） were closely related to the degree of cerebral arterial stenosis due to cerebrovascular atherosclerosis whereas the relationship was not obviously between DDI, Fg, vWF and the degree of cerebral arterial stenosis. Hypertensive （P=0.029,OR=4.582） was the risk factor of cerebral vascular stenosis, and was significantly related with cerebral vascular stenosis. Conclusions hs-CRP,TpP, Lpot and hypertension were correlated with the degree of stenosis of cerebrovascular in acute cerebral infarction patients caused by atherosclerosis. The possibility of cerebrovascular severe stenosis increased in acute cerebral infarction patients whose content of hs-CRP, TpP, Lpα were also increased in serum accompanied with hypertension.