急性缺血性脑卒中患者血清铁调素25及铁代谢指标变化及临床意义

Change of serum hepcidin 25 and iron metabolism indicator in acute ischemic stroke patients and its clinical significance

目的探讨急性缺血性脑卒中(AIS)患者血清铁调素25及铁代谢指标的变化及其与病情严重程度和早期预后的关系。方法选择AIS患者178例作为病例组,神经功能缺损程度按美国国立卫生研究院卒中量表评分评定,并分为轻型57例、中型62例和重型59例,检测发病后24h、3、7、14和28d时血清铁调素25和铁蛋白水平。另选同期健康体检者150例作为对照组。结果病例组发病24h、3、7、14和28d血清铁调素25[(34.99±10.85)μg/L,(42.63±8.12)μg/L,(47.67±5.29)μg/L,(32.28±5.49)μg/L,(28.64±1.53)μg/L vs(22.65±4.88)μg/L,P=0.000]、铁蛋白[(208.38±22.35)μg/L,(280.56±18.11)μg/L,(299.44±18.07)μg/L,(97.88±15.19)μg/L和(90.67±10.92)μg/L vs(77.51±21.22)μg/L,P=0.000]高于对照组。病例组在不同时间点以及轻、中、重型患者血清铁调素25、铁蛋白水平比较,差异有统计学意义(P<0.01)。血清铁调素25水平与铁蛋白及白细胞介素6呈正相关(r=0.992,0.809,P<0.01)。结论血清铁调素25和铁蛋白水平可作为判断AIS病情严重程度及预后的生物学指标,提示铁代谢可能参与了脑梗死的全过程。

Objective To study the change of serum hepcidin 25 and iron metabolism indicator in acute ischemic stroke（AIS）patients and its association with the severity and early outcome of AIS.Methods One hundred and seventy-eight AIS patients served as an AIS group and were further divided into mild AIS group（n=57）,moderate AIS group（n=62）,and severe AIS group（n=59）according to their NIHSS score.Their serum hepcidin 25 and ferritin levels were measured at 24 hand on days 3,7,14,28 after onset of AIS.One hundred and fifty subjects who underwent physical examination served as a control group.Results The serum hepcidin 25 and ferritin levels were significantly higher in AIS group than in control group at 24 hand on days 3,7,14,28 after onset of AIS（P〈0.05,P〈0.01）and differed greatly in mild,moderate and severe AIS groups（P〈0.01）.The serum level of hepcidin 25 was positively associated with those of ferritin and IL-6（r=0.992,r=0.809,P〈0.01）.Conclusion The serum hepcidin 25 and ferritin levels can be used as a bioindicator of the severity and outcome of AIS.Iron metabolism may be involved in ischemic stroke.