血清IL-6、MMP-9、SAA、hs-CRP及RBP4与老年急性脑梗死患者预后的关系研究

Research on the relationship of serum IL-6,MMP-9,SAA,hsCRP and RBP4 with the prognosis of elderly patients with acute cerebral infarction

目的探讨老年急性脑梗死患者血清白细胞介素6(IL-6)、基质金属蛋白酶9(MMP-9)、淀粉样酶A(SAA)、超敏C反应蛋白(hs-CRP)及视黄醇结合蛋白4(RBP4)水平与其预后的关系。方法收集2012年1月至2014年1月诊断为急性脑梗死的老年住院患者86例,设为观察组,另选健康人群40例作为对照组,比较两组之间血清IL-6、MMP-9、SAA、hs-CRP及RBP4水平。另根据患者NIHSS评分,将观察组患者分为神经功能损害轻度组、中度组和重度组,比较三组之间血清IL-6、MMP-9、SAA、hs-CRP及RBP4水平,并根据NIHSS评分比较三组间预后良好率、进展性脑卒中率和病死率。结果与对照组比较,观察组患者血清IL-6、MMP-9、SAA、hs-CRP及RBP4水平均升高,差异有统计学意义(P<0.05);观察组神经功能损害轻度组、中度组和重度组间比较,血清IL-6、MMP-9、SAA、hs-CRP及RBP4水平逐渐升高,差异有统计学意义(P<0.05),三组间性Pearson相关性分析,差异有统计学意义(P<0.05)。另外,与轻度组比较,中度组和重度组预后良好率明显降低,进展性脑卒中率明显增高,病死率明显增高,除轻度组与中度组病死率无明显差异外,其余各项组间比较差异均有统计学意义(P<0.05)。结论老年急性脑梗死患者血清IL-6、MMP-9、SAA、hs-CRP及RBP4水平显著升高,且与病情严重程度呈正相关关系,故可作为判断病情的实验室指标。由于老年急性脑梗死的预后与病情程度密切相关,故血清IL-6、MMP-9、SAA、hs-CRP及RBP4水平也可作为判断预后的指标,对其进行检测和干预有助于对预后的判断和改善。

Objective To study the relationship between the levels of serum IL-6,MMP-9,SAA,hsCRP,RBP4 and the prognosis of elderly patients with acute cerebral infarction. Methods 86 patients with acute cerebral infarction since January 2012 to January 2014 were involved as observation group,40 healthy cases were involved as control group. The serum level of IL- 6,MMP- 9,SAA,hsCRP and RBP4 of both groups were compared. In addition,the observation group were divided into mild,moderate group and severe group according to the NIHSS score. The serum IL- 6,MMP- 9,SAA,hsCRP and RBP4 level,as well as good prognosis rate,stroke rate and mortality,were compared between three groups. Results Compared with control group,the serum IL- 6,MMP- 9,SAA,hsCRP and RBP4 levels of observation group were higher. The difference was statistically significant（ P〈0. 05）. Serum levels of IL- 6,MMP- 9,SAA,hsCRP and RBP4 level of the three groups in observation group were increased gradually. The difference was statistically significant（ P〈0. 05）. The pearson correlation is also statistically significant among the three groups（ P〈0. 05）. In addition,the good prognosis rate,stroke rate and mortality rate of three groups were different. The difference was statistically significant（ P〈0. 05）. Conclusion The serum IL- 6,MMP- 9,SAA,hsCRP and RBP4 levels of elderly patients with acute cerebral infarction were obviously increased and positively correlated with disease severity. Therefore,these indexes can be used as a judging index of laboratory. Moreover,the prognosis of elderly acute cerebral infarction is closely related to the degree of illness. Therefore,the serum IL- 6,MMP- 9,SAA,hsCRP and RBP4 level can be used as a prognosis indicators,the detection and intervention,which will help to judge and improve the prognosis.