内皮细胞特异性分子1与脑动脉粥样硬化程度及大动脉粥样硬化型脑梗死预后的关系

Relationship of endothelial specific molecular 1with cerebral atherosclerosis and prognosis of LAA cerebral infarction

目的探讨内皮细胞特异性分子(Endocan)与脑动脉粥样硬化(AS)广泛程度及大动脉粥样硬化型(LAA)脑梗死患者预后的关系。方法选择脑梗死患者155例,按照TOAST分型分为LAA组105例,小动脉闭塞型(SAO)组50例,同期另选无症状脑动脉狭窄患者33例为无症状狭窄组,健康对照者60例为对照组。将LAA组按AS病变分为单支、双支、多支病变。用ELISA血浆Endocan水平。LAA组随访3个月,行改良Rankin量表(mRS)评分,用ROC曲线评估Endocan对LAA脑梗死患者预后的预测价值。结果 LAA组血浆Endocan水平(1.29±0.40)μg/L,SAO组(1.01±0.32)μg/L,无症状狭窄组(1.26±0.38)μg/L,对照组(1.00±0.31)μg/L,LAA组高于SAO组和对照组(P<0.01),无症状狭窄组高于SAO组和对照组(P<0.01)。LAA组多支、双支、单支病变血浆Endocan水平有显著差异(P<0.05,P<0.01)。LAA组患者血浆Endocan水平与mRS评分及AS广泛程度呈正相关(P=0.000),Endocan判断预后的ROC曲线下面积为0.652。结论血浆Endocan水平与AS广泛程度相关,有潜力成为评价AS广泛程度和判断LAA脑梗死患者预后的血浆标记物。

objective To study the relationship of endothelial specific molecular 1（Endocan）with the severity of cerebral atherosclerosis and the prognosis of LAA cerebral infarction（CI）.Methods 155 CI patients were divided into LAA group（n=105）,SAO group（n=50）,an additional33 patients with asymptomatic cerebral artery stenosis served as an asymptomatic stenosis group and 60 healthy persons served as a control group in this study.Patients in LAA group were further divided into single lesion group,double lesion group,and multiple lesion group.Their serum Endocan level was measured.Patients in LAA group were followed up for 3 months and scored according to the mRS.Role of serum Endocan level in predicting the prognosis of LAA CI patients was assessed according to the ROC curve.Results The serum Endocan level is significantly higher in LAA group than in SAO group and control group,and in asymptomatic stenosis group than in SAO group and control group（P〈0.01）.The serum Endocan level was positively related with the mRS score in LAA group（P=0.000）.The serum Endocan level among three subgroups was statistically different（P〈0.01）.The area under the ROC curve was 0.652.Conclusion Serum Endocan level is related with the severity of cerebral atherosclerosis and can thus be used as a plasma marker for assessing the severity of atherosclerosis and the prognosis of LAA CI patients.