急性脑梗死患者脂联素、一氧化氮合酶与颈动脉粥样硬化的关系

The relationship of adiponectin、nitric oxide synthase and carotid atherosclerosis in patients with acute cerebral infarction

目的探讨急性脑梗死(ACI)患者脂联素(ADP)、一氧化氮合酶(NOS)与颈动脉粥样硬化(CAS)的关系。方法检测77例ACI患者(CI组)(发病<48 h和第10 d)及54例正常对照者(NC组)ADP、结构型NOS(c NOS)、诱生型NOS(i NOS)水平。颈动脉超声检测两组CAS情况。CI组行神经功能缺损评分。结果 CI组发病<48h和第10d及NC组ADP、NOS差异显著(P<0.05,P<0.01),CI组及NC组CAS发生率、不稳定斑块构成比差异显著(P<0.05,P<0.01)。CI组ADP差值与颈总动脉IMT独立正相关(β=0.129,P=0.049),发病<48hc NOS与颈总动脉IMT及同期神经功能缺损评分均呈独立负相关(β=﹣0.032,P=0.006;β=﹣0.218,P=0.005)。结论 ACI患者发病早期ADP及c NOS降低,i NOS升高,且均有明显动态变化。CAS与CI密切相关,且不稳定斑块与CI关系更密切。c NOS水平随CAS及CI病变程度的加重而降低,可反应CI的病情。

Objective：To investigate the relationship of serum adiponectin（ADP）,nitric oxide synthase（NOS）and ca-rotid atherosclerosis（CAS）in patients with acute cerebral infarction（ACI）. Methods：Measured the levels of serum ADP, constitutive（cNOS）,inducible NOS（iNOS）in 77 ACI patients（CI group）（onset 〈 48h and 10d）and 55 normal controls （NC group）. Detected carotid atherosclerosis of two groups with carotid Doppler. Neurologic deficits degree of CI group were evaluated. Results：The levels of ADP and NOS at onset 〈 48h and 10d in CI group had significant differences as com-pared with that of NC group（P 〈 0. 05,P 〈 0. 01）. CAS incidence rate and constituent ratio of unstable plaque in CI group were significantly higher（P 〈 0. 01,P 〈 0. 05）. Subtraction value of ADP in CI group had positive correlation with carotid IMT（β = 0. 129,P = 0. 049）. The level of cNOS at onset 〈 48h in CI group was negative correlated with carotid IMT and neurologic deficits degree（β = - 0. 032,P = 0. 006;β = - 0. 218,P = 0. 005）. Conclusion：The ADP and cNOS levels were decreased and the iNOS levels were increased in early stage of CI,and all had dynamic changes. CAS had close rala-tionship with CI,the relationship between unstable plague and CI was closer. The heavier the lesion of CI and CAS,the lower the level of cNOS,cNOS may reflect the severity of CI.